Clinical characteristics and outcomes of newly diagnosed patients with HIV‐associated aggressive B‐cell NHL in China

Abstract

Little is known about the incidence, clinical characteristics and prognostic factors in HIV associated lymphoma as these are less common than HIV‐negative lymphoma in China. Currently, there are no standard guidelines for treatment of these patients. Therefore, we performed a study to analyse the clinical characteristics and outcomes of newly diagnosed HIV‐associated aggressive B‐cell non‐Hodgkin's lymphoma (NHL) patients in Chongqing University Cancer Hospital (CUCH). Totally 86 newly diagnosed HIV‐associated aggressive B‐cell NHL patients in CUCH, southwest China, from July 2008 to August 2021, were analysed. In the entire cohort, median age was 48 years (range, 23–87 years), and more patients were male (87.2%). Most patients had elevated lactate dehydrogenase (LDH) (82.6%), advanced ann arbor stage (80.2%) and high IPI score (IPI score, 3–5) (62.7%) at diagnosis. Median CD4+ T‐cell count at diagnosis was 191/μl (range, 4–1022), 84 patients (97.7%) were on combination antiretroviral therapy (cART) at lymphoma diagnosis. In DLBCL patients, cox multivariate analysis showed that age ≥ 60 (HR = 2.251, 95%CI 1.122–4.516; p = 0.012), elevated LDH (HR = 4.452, 95%CI 1.027–19.297; p = 0.041) and received less than two cycles of chemotherapy (HR = 0.629, 95%CI 0.589–1.071; p = 0.012) were independent risk factors for adverse prognosis based on PFS. Age ≥ 60 (HR = 3.162, 95%CI 1.500–6.665; p = 0.002) and received less than two cycles of chemotherapy (HR = 0.524, 95%CI 0.347–0.791; p = 0.002) were also independent risk factor for adverse prognosis based on OS. In BL patients, cox multivariate analysis showed that elevated LDH and received less than two cycles of chemotherapy were independent risk factors for adverse prognosis. In the DLBCL group, median PFS times in the received rituximab and no received rituximab groups were not reached and 12 months, respectively (p = 0.006). Median OS times were not reached and 36 months, respectively (p = 0.021). In the BL group, median PFS times in the received rituximab and no received rituximab groups were not reached and 4.8 months, respectively (p = 0.046). Median OS times were not reached and 10.1 months, respectively (p = 0.035). Overall, these data indicated that standardized anti‐lymphoma therapy and rituximab administration were significantly associated with improved outcomes in patients with HIV‐associated DLBCL and BL.

Use of Programmed Cell Death Protein 1 (PD-1) Inhibitor Therapy in HIV-infected Patients with Advanced Cancer:a single-center study from China

“…The estimated 1-year OS rate was 66.7%, which also resembled that reported by Kathryn Lurain et al [22]. These data were signi cantly higher than that in cancer patients among PLWH without PD-1 inhibitors [27,28].…”

“…This study is limited by the small sample size. Meanwhile, all the patients included were male, as PLWH are more commonly male in China, as well as those with cancers [27,42]. Larger research is required to validate the promising and favorable anticancer activity with PD-1 inhibitors treatmentforPLWH.…”

Impact of initial chemotherapy cycles and clinical characteristics on outcomes for HIV-associated diffuse large B cell lymphoma patients: The Central and Western China AIDS Lymphoma League 001 study (CALL-001 study)

“…In our previous singlecenter study, of all 86 HIV-associated aggressive B-cell lymphoma patients, 22 (25.6%) did not receive chemotherapy because of fear of discrimination and poor financial situation, including 16 DLBCL patients (8). Once the chemotherapy is given up, the prognosis of the patients will become very poor (8,(20)(21)(22)(23)(24). Based on this, we carried out this study.…”

“…22 patients (25.6%) received no anti-lymphoma chemotherapy because of fear of discrimination and poor financial situation. Median survival times in the patients who no received any anti-lymphoma chemotherapy was only 3.5 months, which was significantly lower than that of patients receiving chemotherapy ( p< 0.001) ( 8 ).…”

HIV‐associated Burkitt lymphoma in the combination antiretroviral therapy era: Real‐world outcomes and prognostication

“…Since 2017, the incidence of HIV‐associated NHL has been higher than that of KS, becoming the highest incidence rate among HIV‐associated cancers [ 2 ]. Burkitt's lymphoma (BL) is the second common subtype of HIV‐associated NHL after diffuse large B‐cell lymphoma (DLBCL) [ 3 ].…”