{"id":16425,"date":"2012-06-01T13:40:57","date_gmt":"2012-06-01T13:40:57","guid":{"rendered":"http:\/\/i-base.info\/htb\/?p=16425"},"modified":"2013-08-12T12:07:29","modified_gmt":"2013-08-12T12:07:29","slug":"hodgkins-lymphoma-survival-normalises-to-hiv-negative-rates-despite-more-advanced-disease-at-diagnosis","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/16425","title":{"rendered":"Hodgkin’s lymphoma: survival normalises to HIV negative rates despite more advanced disease at diagnosis"},"content":{"rendered":"

Simon Collins, HIV i-Base<\/strong><\/p>\n

High levels of treatment response to chemotherapy for Hodgkin’s Lymphoma (HL) in the HAART era were reported in a combined analysis from five clinics, showing similar rates of event-free and overall survival compared to HIV negative controls.<\/strong><\/p>\n

Chloe Orkin and colleagues analysed all cases of HL diagnosed at five London teaching hospitals from 1997-2010 who were treated with 4-6 cycles of AVBD (adriamycin, bleomycin, viznblastine and dacarbazine). Of these, 97\/237 were HIV positive and 90\/97 were on HAART during HL treatment. HIV viral load was undetectable in 52\/86 HIV positive patients with data and low (<6,000 c\/mL) in others but 53% (47\/97) had CD4 <200 cells\/mm3.<\/p>\n

HIV patients were older (median age: 41 vs 31 years, p<0.001), more likely to be male (88% vs 59%; p<0.001). They also had more advanced disease. This included higher rates of: mixed cellularity (54% vs 19%, p<0.001), stage 3\/4 at diagnosis (80% vs 33%; p<0.001), B-symptoms (81% vs 36%; p<0.001), Hb <10.5 g\/dL (46% vs 20%; p<0.001), albumin <4 g\/dL (76% vs 35%, p<0.001) and a higher International Prognostic Score (IPS 3 in 71% vs 22%; p<0.001).<\/p>\n

Over median follow-up of 59 months (range 8-172), similar response rates (74% vs 81%), duration of response (33 vs 44 months), 5-year event-free survival (59% vs 65%) and 5-year overall survival (79% vs 88%) were seen in the HIV positive vs HIV negative groups respectively, see Table 1. In the combined group, 40 patients relapsed at a median time of 7 months (range: 1-106).<\/p>\n\n\n\n\n\n\n\n
Table 1: Responses to ABVD chemotherapy in HIV positive vs HIV negative people<\/caption>\n
<\/td>\nHIV positive<\/th>\nHIV negative<\/th>\np-value<\/th>\n<\/tr>\n
Complete response rate<\/th>\n74%<\/td>\n81%<\/td>\nNS<\/td>\n<\/tr>\n
Median duration of response<\/th>\n33 mo<\/td>\n48 mo<\/td>\nNS<\/td>\n<\/tr>\n
5-yr event-free survival<\/th>\n59%(95%CI: 46\u2013 69)<\/td>\n65%(95%CI: 56\u201372)<\/td>\nNS<\/td>\n<\/tr>\n
5-yr overall survival<\/th>\n79%(95%CI: 67\u201387)<\/td>\n88%(95%CI: 80\u201392)<\/td>\np=0.06 (NS)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

comment<\/h3>\n

These results are important and impressive, despite including data from the early HAART era, and especially given the more advanced disease at HL diagnosis.<\/strong><\/p>\n

Reference:<\/p>\n

Orkin C et al. HIV Status does not Impact on Outcome in Patients with Hodgkin Lymphoma Treated with ABVD Chemotherapy in the HAART Era. 18th BHIVA Conference, 18-20 April 2012, Birmingham. Oral abstract O13.<\/p>\n

View slides<\/a> (PDF). View webcast<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

Simon Collins, HIV i-Base High levels of treatment response to chemotherapy for Hodgkin’s Lymphoma (HL) in the HAART era were reported in a combined analysis from five clinics, showing similar rates of event-free and overall survival compared to HIV negative …<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,31],"tags":[11],"class_list":["post-16425","post","type-post","status-publish","format-standard","hentry","category-conference-reports","category-opportunistic-infections-coinfections-and-complications","tag-bhiva-18th-2012"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/16425","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=16425"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/16425\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=16425"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=16425"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=16425"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}