HIV Infection and Survival of Lymphoma Patients in the Era of Highly Active Antiretroviral Therapy

Han, Xuesong; Jemal, Ahmedin; Hulland, Erin; Simard, Edgar P.; Nastoupil, Loretta J.; Ward, Elizabeth; Flowers, Christopher R.

doi:10.1158/1055-9965.epi-16-0595

Cited by 59 publications

(50 citation statements)

References 38 publications

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“…Treatment outcomes for patients with HIV-related lymphoma have improved in the era of effective antiretroviral therapy (ART), in particular for DLBCL and Burkitt lymphoma, and curability of HIVrelated lymphoma is considered similar to that of HIV-unrelated lymphoma 8. However, we found that patients with HIV-related DLBCL had worse survival, consistent with a recent US study 9. A previous study conducted by the Eastern Cooperative Oncology Group showed that rituximab plus chemotherapy is very effective to treat HIV-associated B-cell NHL among patients aged ≥18 years, and no increase of infection-related deaths was observed 10.…”

supporting

confidence: 89%

Survival after diffuse large B‐cell lymphoma among children, adolescents, and young adults in California, 2001–2014: A population‐based study

Abrahão

Ribeiro

Lichtensztajn

et al. 2018

Pediatric Blood & Cancer

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Background This population‐based study considered the influence of rituximab on the survival of children (0–19 years), adolescents, and young adults (AYAs, 20–39 years) with diffuse large B‐cell lymphoma (DLBCL), including patients with human immunodeficiency virus (HIV) infection. Methods Data on 642 children and AYAs diagnosed with DLBCL during 2001–2014 were obtained from the Greater Bay Area Cancer Registry in California. Facility‐level reports provided treatment details. The Kaplan–Meier method estimated survival and Cox regression models examined the association between survival and rituximab use, adjusting for sociodemographic and clinical factors. Results Rituximab use increased from 2001–2007 to 2008–2014 among children (from 32% to 48%), AYAs (from 68% to 84%), and HIV patients (from 57% to 67%). Five‐year survival was higher among children (91%) than AYAs (82%). On multivariable analysis, the hazard of death was 44% lower among rituximab recipients, and higher among uninsured patients, those with HIV, and those with advanced stage at diagnosis. HIV patients who received rituximab were 60% less likely to die than nonrecipients. Conclusions Our study suggests a benefit of rituximab on the treatment of AYAs and HIV patients with DLBCL. The worse survival observed among HIV‐positive and uninsured patients is of concern and calls for further investigation. Careful consideration should be given on whether to recommend rituximab more often on the front‐line treatment of children and HIV‐positive patients with DLBCL.

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supporting

confidence: 89%

Survival after diffuse large B‐cell lymphoma among children, adolescents, and young adults in California, 2001–2014: A population‐based study

Abrahão

Ribeiro

Lichtensztajn

et al. 2018

Pediatric Blood & Cancer

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“…197 One large database study, however, found that overall survival was decreased in PLWH and HL (hazard ratio [HR], 1.47; 95% CI, 1.25-1.74), even though the population was matched by treatment characteristics. 198 Cancer-specific survival was not assessed in this study.…”

Section: Management Of Hl In Plwhmentioning

confidence: 99%

Cancer in People Living With HIV, Version 1.2018, NCCN Clinical Practice Guidelines in Oncology

Reid¹,

Suneja²,

Ambinder³

et al. 2018

J Natl Compr Canc Netw

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People living with HIV (PLWH) are diagnosed with cancer at an increased rate over the general population and generally have a higher mortality due to delayed diagnoses, advanced cancer stage, comorbidities, immunosuppression, and cancer treatment disparities. Lack of guidelines and provider education has led to substandard cancer care being offered to PLWH. To fill that gap, the NCCN Guidelines for Cancer in PLWH were developed; they provide treatment recommendations for PLWH who develop non-small cell lung cancer, anal cancer, Hodgkin lymphoma, and cervical cancer. In addition, the NCCN Guidelines outline advice regarding HIV management during cancer therapy; drug-drug interactions between antiretroviral treatments and cancer therapies; and workup, radiation therapy, surgical management, and supportive care in PLWH who have cancer.

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“…The incidence of cHL in the HIV setting have increased 5-25-fold, suggesting that despite suppressive cART, the ongoing immune suppression (driven by ongoing HIV replication among other factors) and the aged population have contributed to this rise [7][8][9][10][11][12][13]. On the other hand, individuals with severe immune suppression have a lower cHL incidence, suggesting that the improvement of CD4 counts associated to cART and the rise of immune competence may explain the observed increase of cHL incidence [14][15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Risk, Diagnostic and Predictor Factors for Classical Hodgkin Lymphoma in HIV-1-Infected Individuals: Role of Plasma Exosome-Derived miR-20a and miR-21

Hernández-Walias

Vázquez

Pacheco

et al. 2020

JCM

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The incidence of classical Hodgkin lymphoma (cHL) in the HIV-1 setting has increased 5–25-fold compared to that observed in the general population. This study aimed to determine whether selected micro RNAs (miRs) and other soluble biomarkers and cellular subsets are dysregulated in cHL and could be used as biomarkers. This was a retrospective and longitudinal matched case-control study of 111 Caucasian, HIV-1-infected adult individuals, including 37 individuals with cHL and 74 with no type of cancer. Immunovirological data, plasma exosome-derived miR-16, miR-20a, miR-21, miR-221, miR-223, miR-106a, miR-185, miR-23, miR-30d, miR-222, miR-146a and miR-324, plasma IL-6, sCD14, sCD27, sCD30, sIL-2R, TNFR1, and cell phenotyping of T and B lymphocytes and natural killer (NK) cells were analyzed. Before cHL diagnosis, miR-20a, miR-21, and sCD30 were higher in cHL (p = 0.008, p = 0.009 and p = 0.042, respectively), while miR-16 was down-regulated (p = 0.040). miR-20a and miR-21 were independently associated with cHL (p = 0.049 and p = 0.035, respectively). The combination of miR-20a and miR-21 showed a good AUC value of 0.832 with a moderate likelihood ratio positive (LR+) value of 5.6 and a slight likelihood ratio negative (LR−) value of 0.23. At cHL diagnosis, miR-20a, miR-21 and miR-324 were overexpressed in cHL (p = 0.005, p = 0.024, and p = 0.001, respectively), while miR-223, miR-16, miR-185 and miR-106a were down regulated (p = 0.042, p = 0.007, p = 0.006, and p = 0.002, respectively). In addition, sCD14, sCD27, sCD30 and IL2R levels were higher in these individuals (p = 0.038, p = 0.010, p = 0.030, p = 0.006, respectively). miR-20a was independently associated with cHL (p = 0.011). The diagnostic value of miR-20a showed good AUC value of 0.754 (p = 0.074) with a slight LR+ value of 2 and a slight LR− of 0.25. After chemotherapy, miR-20a was higher in those individuals who had an adverse outcome (p < 0.001), while sCD14 and sCD30 were higher (p < 0.001). A specific signature of miRs and cytokines associated with a subsequent cHL diagnosis was found in this study, especially miR-20a and miR-21. Also, another biomarker signature was found at cHL diagnosis, with a relevant discriminant disease value for miR-20a. Of note, miR-20a expression was higher in those individuals who had an adverse clinical outcome after chemotherapy.

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HIV Infection and Survival of Lymphoma Patients in the Era of Highly Active Antiretroviral Therapy

Abstract: Background: Highly active antiretroviral therapy

Cited by 59 publications

References 38 publications

Survival after diffuse large B‐cell lymphoma among children, adolescents, and young adults in California, 2001–2014: A population‐based study

Survival after diffuse large B‐cell lymphoma among children, adolescents, and young adults in California, 2001–2014: A population‐based study

Cancer in People Living With HIV, Version 1.2018, NCCN Clinical Practice Guidelines in Oncology

Risk, Diagnostic and Predictor Factors for Classical Hodgkin Lymphoma in HIV-1-Infected Individuals: Role of Plasma Exosome-Derived miR-20a and miR-21

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