1. Prognosis of HIV-associated non-Hodgkin lymphoma in patients starting combination antiretroviral therapy
- Author
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Bohlius, Julia, Schmidlin, Kurt, Costagliola, Dominique, Fätkenheuer, Gerd, May, Margaret, Murillo, Ana Maria Caro, Mocroft, Amanda, Bonnet, Fabrice, Clifford, Gary, Touloumi, Giota, Miro, Jose M., Chene, Genevieve, Lundgren, Jens, Egger, Matthias, Antinori, Andrea, Boué, François, Brockmeyer, Norbert, Casabona, Jordi, Lopez-Guillermo, Armando, Ribera, Josep Maria, Dronda, Fernando, Obel, Niels, Fisher, Martin, Franceschi, Silvia, Gibb, Diana, Le Moing, Vincent, Nadal, David, Prins, Maria, Raffi, François, Roca, Bernardino, Verbon, Annelies, Wolf, Timo, Fortuny, Claudia, Chakraborty, Rana, Minder, Christoph, Sterne, Jonathan, Zwahlen, Marcel, Ellefson, Michelle, Kjaer, Jesper, Collin, Fidéline, Colin, Céline, Weller, Ian, Ledergerber, Bruno, Warszawski, Josiane, Meyer, Laurence, Dabis, François, Krause, Murielle Mary, Goujard, Cecile, Leport, Catherine, de Wolf, Frank, Reiss, Peter, Porter, Kholoud, Dorrucci, Maria, Sabin, Caroline, Del Amo, Julia, Thorne, Claire, Kirk, Ole, Staszewski, Schlomo, Perez-Hoyos, Santiago, Almeda, Jesus, D'Arminio Monforte, Antonella, de Martino, Maurizio, Ramos, Jose, Battegay, Manuel, Mussini, Cristina, Tookey, Pat, Castagna, Antonella, de Wit, Stephane, Torti, Carlo, Teira, Ramon, Garrido, Myriam, Dedes, Nikos, Phillips, Andrew, Furrer, Hansjakob, Newell, Marie Louise, Telenti, Amalio, Pantazis, Nikos, Lechenadec, Jérôme, Boufassa, Faroudy, Tran, Laurent, Balestre, Eric, Lanoy, Emilie, Couturier, Françoise, Rispens, Theo, Gras, Luuk A.J., Bhaskaran, Krishnan, Hill, Teresa, Judd, Ali, Duong, Trinh, Sobrino, Paz, Jennings, Beverley, Bonfigli, Sandro, Cozzi-Lepri, Alessandro, Corvasce, Stefano, Adorni, Fulvio, Ridolfo, Anna Lisa, Paraninfo, Giuseppe, Keiser, Olivia, Borghi, Vanni, Weller, Ian, Costagliola, Dominique, Ledergerber, Bruno, Lundgren, Jen, Chene, Genevieve, Touloumi, Giota, Warszawski, Josiane, Meyer, Laurence, Dabis, Francoi, Krause Murielle, Mary, Leport, Catherine, de Wolf, Frank, Reiss, Peter, Porter, Kholoud, Dorrucci, Maria, Sabin, Caroline, Gibb, Diana, Del Amo, Julia, Obel, Niel, Thorne, Claire, Mocroft, Amanda, Kirk, Ole, Staszewski, Schlomo, Perez Hoyos, Santiago, Almeda, Jesu, Antinori, Andrea, Monforte A., D'Arminio, de Martino, Maurizio, Brockmeyer, Norbert, Faetkenheuer, Gerd, Ramos, Jose, Battegay, Manuel, Mussini, Cristina, Tookey, Pat, Casabona, Jordi, Miro Jose, M., Castagna, Antonella, de Wit, Stephane, Torti, Carlo, Teira, Ramon, Garrido, Myriam, Dedes, Niko, Phillips, Andrew, Furrer, Hansjakob, Egger, Matthia, Newell Marie, Louise, Sterne, Jonathan, Telenti, Amalio, AII - Amsterdam institute for Infection and Immunity, APH - Amsterdam Public Health, and Infectious diseases
- Subjects
Cart ,Adult ,Male ,medicine.medical_specialty ,Adolescent ,Immunology ,AIDS-related lymphoma ,Young Adult ,immune system diseases ,Internal medicine ,hemic and lymphatic diseases ,Antiretroviral Therapy, Highly Active ,Epidemiology ,medicine ,Immunology and Allergy ,Humans ,Young adult ,Mortality ,Prospective cohort study ,Collaborative study ,Immunodeficiency ,Non-Hodgkin lymphoma ,Lymphoma, AIDS-Related ,business.industry ,Lymphoma, Non-Hodgkin ,Middle Aged ,medicine.disease ,Prognosis ,Surgery ,Lymphoma ,Antiretroviral therapy ,CD4 Lymphocyte Count ,Europe ,Infectious Diseases ,Treatment Outcome ,HIV-1 ,Cohort studies ,Female ,business ,Epidemiologic Methods ,Cohort study - Abstract
Objective: We examined survival and prognostic factors of patients who developed HIV-associated non-Hodgkin lymphoma (NHL) in the era of combination antiretroviral therapy (cART). Design and setting: Multicohort collaboration of 33 European cohorts. Methods: We included all cART-naive patients enrolled in cohorts participating in the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) who were aged 16 years or older, started cART at some point after 1 January 1998 and developed NHL after 1 January 1998. Patients had to have a CD4 cell count after 1 January 1998 and one at diagnosis of the NHL. Survival and prognostic factors were estimated using Weibull models, with random effects accounting for heterogeneity between cohorts. Results: Of 67 659 patients who were followed up during 304 940 person-years, 1176 patients were diagnosed with NHL. Eight hundred and forty-seven patients (72%) from 22 cohorts met inclusion criteria. Survival at 1 year was 66% [95% confidence interval (CI) 63-70%] for systemic NHL (n = 763) and 54% (95% CI: 43-65%) for primary brain lymphoma (n = 84). Risk factors for death included low nadir CD4 cell counts and a history of injection drug use. Patients developing NHL on cART had an increased risk of death compared with patients who were cART naive at diagnosis. Conclusion: In the era of cART two-thirds of patients diagnosed with HIV-related systemic NHL survive for longer than 1 year after diagnosis. Survival is poorer in patients diagnosed with primary brain lymphoma. More advanced immunodeficiency is the dominant prognostic factor for mortality in patients with HIV-related NHL.
- Published
- 2009