TY - JOUR
T1 - Postautologous stem cell transplantation long-term outcomes in 26 HIV-positive patients affected by relapsed/refractory lymphoma
AU - Zanet, Ernesto
AU - Taborelli, Martina
AU - Rupolo, Maurizio
AU - Durante, Cristina
AU - Mazzucato, Mario
AU - Zanussi, Stefania
AU - De Paoli, Paolo
AU - Serraino, Diego
AU - Tirelli, Umberto
AU - Lleshi, Arben
AU - Michieli, Mariagrazia
PY - 2015/11/1
Y1 - 2015/11/1
N2 - Objectives: To describe survival data, CD4 + T-cell long-term dynamics and the correlation between dynamics and events occurrence in 26 HIV-positive patients with refractory lymphoma in complete response after autologous stem cell transplantation (ASCT). Design: Retrospective single-centre study. Methods: Lymphoma relapse, second cancers and opportunistic infections were considered after ASCT. Group A included patients experiencing events after ASCT and group B the remaining patients. Overall survival, progression-free survival and event-free survival probabilities were estimated by Kaplan-Meier method. The comparison of median CD4 + T-cell count at cancer diagnosis with matched values was investigated by Wilcoxon signed-rank test and between group A and B by Mann-Whitney U test. Results: With a median of 6-year follow-up, the overall survival, the progression-free survival and the event-free survival at 10 years were 91, 86 and 36%. Compared with CD4 + T-cell count at cancer diagnosis a higher amount was maintained over time after ASCT. Two patients experienced a lymphoma relapse at 4.3 and 3.1 years; five patients had secondary malignancies and nine patients opportunistic infections at a median time of 2.2 and 0.4 years from ASCT. At 6 and 12 months after ASCT, a significant difference in CD4 + T-cell count was found between group A and B. Conclusion: ASCT has a dramatic impact on survival of HIV-positive patients with refractory lymphoma. We support surveillance of opportunistic infections early after ASCT and of second cancers or lymphoma relapses later from ASCT. Both opportunistic infections and second malignancies were successfully managed and the only long-term death occurred due to lymphoma relapse. ASCT seems to contribute to immune recovery.
AB - Objectives: To describe survival data, CD4 + T-cell long-term dynamics and the correlation between dynamics and events occurrence in 26 HIV-positive patients with refractory lymphoma in complete response after autologous stem cell transplantation (ASCT). Design: Retrospective single-centre study. Methods: Lymphoma relapse, second cancers and opportunistic infections were considered after ASCT. Group A included patients experiencing events after ASCT and group B the remaining patients. Overall survival, progression-free survival and event-free survival probabilities were estimated by Kaplan-Meier method. The comparison of median CD4 + T-cell count at cancer diagnosis with matched values was investigated by Wilcoxon signed-rank test and between group A and B by Mann-Whitney U test. Results: With a median of 6-year follow-up, the overall survival, the progression-free survival and the event-free survival at 10 years were 91, 86 and 36%. Compared with CD4 + T-cell count at cancer diagnosis a higher amount was maintained over time after ASCT. Two patients experienced a lymphoma relapse at 4.3 and 3.1 years; five patients had secondary malignancies and nine patients opportunistic infections at a median time of 2.2 and 0.4 years from ASCT. At 6 and 12 months after ASCT, a significant difference in CD4 + T-cell count was found between group A and B. Conclusion: ASCT has a dramatic impact on survival of HIV-positive patients with refractory lymphoma. We support surveillance of opportunistic infections early after ASCT and of second cancers or lymphoma relapses later from ASCT. Both opportunistic infections and second malignancies were successfully managed and the only long-term death occurred due to lymphoma relapse. ASCT seems to contribute to immune recovery.
KW - autologous stem cell transplantation
KW - cancer survivors
KW - HIV infection
KW - long-term outcomes
KW - relapsed/refractory lymphoma
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U2 - 10.1097/QAD.0000000000000851
DO - 10.1097/QAD.0000000000000851
M3 - Article
C2 - 26418085
AN - SCOPUS:84983164685
VL - 29
SP - 2303
EP - 2308
JO - AIDS
JF - AIDS
SN - 0269-9370
IS - 17
ER -