Clinical, virologic, and immunologic outcomes in lymphoma survivors and in cancer-free, HIV-1-infected patients: A matched cohort study

Vincenzo Spagnuolo, Giovanna Travi, Laura Galli, Francesca Cossarini, Monica Guffanti, Nicola Gianotti, Stefania Salpietro, Adriano Lazzarin, Antonella Castagna

Research output: Contribution to journalArticle

Abstract

BACKGROUND The objective of this study was to compare immunologic, virologic, and clinical outcomes between living human immunodeficiency virus (HIV)-infected individuals who had a diagnosis of lymphoma versus outcomes in a control group of cancer-free, HIV-infected patients. METHODS In this matched cohort study, patients in the case group were survivors of incident lymphomas that occurred between 1997 and June 2010. Controls were living, cancer-free, HIV-infected patients who were matched to cases at a 4:1 ratio by age, sex, nadir CD4 cell count, and year of HIV diagnosis. The date of lymphoma diagnosis served as the baseline in cases and in the corresponding controls. RESULTS In total, 62 patients (cases) who had lymphoma (20 with Hodgkin disease [HD] and 42 with non-Hodgkin lymphoma [NHL]) were compared with 211 controls. The overall median follow-up was 4.8 years (interquartile range, 2.0-7.9 years). The CD4 cell count at baseline was 278 cells/mm3 (interquartile range, 122-419 cells/mm3) in cases versus 421 cells/mm3 (interquartile range, 222-574 cells/mm3) in controls (P =.003). At the last available visit, the CD4 cell count was 412 cells/mm3 (range, 269-694 cells/mm3) in cases versus 518 cells/mm3 (interquartile range, 350-661 cells/mm3) in controls (P =.087). The proportion of patients who achieved virologic success increased from 30% at baseline to 74% at the last available visit in cases (P =.008) and from 51% to 81% in controls (P =.0286). Patients with HD reached higher CD4 cell counts at their last visit than patients with NHL (589 cells/mm3 [range, 400-841 cells/mm3] vs 332 cells/mm3 [interquartile range, 220-530 cells/mm3], respectively; P =.003). Virologic success was similar between patients with HD and patients with NHL at the last visit. Forty cases (65%) and 76 controls (36%) experienced at least 1 clinical event after baseline (P

Original languageEnglish
Pages (from-to)2710-2719
Number of pages10
JournalCancer
Volume119
Issue number15
DOIs
Publication statusPublished - Aug 1 2013

Keywords

  • cancer survivors
  • clinical events
  • human immunodeficiency virus
  • immune recovery
  • lymphoma

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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