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 Blood, 15 May 2006, Vol. 107, No. 10, pp. 3832-3840.
Prepublished online as a Blood First Edition Paper on January 12, 2006; DOI 10.1182/blood-2005-09-3600.

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CLINICAL TRIALS AND OBSERVATIONS

AIDS-related non-Hodgkin lymphoma: final analysis of 485 patients treated with risk-adapted intensive chemotherapy

Nicolas Mounier, Michele Spina, Jean Gabarre, Martine Raphael, Giuliano Rizzardini, Jean-Baptiste Golfier, Emanuela Vaccher, Antonino Carbone, Bertrand Coiffier, Guido Chichino, Andre Bosly, Umberto Tirelli, Christian Gisselbrecht, for the French-Italian cooperative group

From the Groupe d'Etude des Lymphomes de l'Adulte (GELA), Paris, France; and Gruppo Italiano Cooperativo AIDS e Tumori (GICAT), Aviano, Italy.

We aimed to compare AIDS risk–adapted intensive chemotherapy in AIDS-related lymphoma (ARL) patients before and after the advent of highly active antiretroviral therapy (HAART). A total of 485 patients aged from 18 to 67 years were randomly assigned to chemotherapy after stratification according to an HIV score based on performance status, prior AIDS, and CD4+ cell counts below 0.10 x 109/L (100/mm3). A total of 218 good-risk patients (HIV score 0) received ACVBP (doxorubicin, cyclophosphamide, vindesine, bleomycin, and prednisolone) or CHOP (doxorubicin, cyclophosphamide, vincristine, and prednisolone); 177 intermediate-risk patients (HIV score 1), CHOP or low-dose CHOP (Ld-CHOP); and 90 poor-risk patients (HIV score 2-3), Ld-CHOP or VS (vincristine and steroid). The 5-year overall survival (OS) in the good-risk group was 51% for ACVBP versus 47% for CHOP (P = .85); in the intermediate-risk group, 28% for CHOP versus 24% for Ld-CHOP (P = .19); and in the poor-risk group, 11% for Ld-CHOP versus 3% for VS (P = .14). The time-dependent Cox model demonstrated that the only significant factors for OS were HAART (relative risk [RR] 1.6, P < .001), HIV score (RR 1.7, P < .001), and the International Prognostic Index (IPI) score (RR 1.5, P < .001) but not chemotherapy regimen. Our findings indicate that in ARL patients, HIV score, IPI score, and HAART affect survival but not the intensity of the CHOP-based chemotherapy.


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Related Article in Blood Online:

Simplified prognostic indicators for AIDS-related lymphoma
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Blood 2006 107: 3819-3820. [Full Text] [PDF]

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Jaswinder Singh, Ashok K. Malani, Siddhartha Ganguly, Suman Kambhampati, and Nicolas Mounier
Blood 2006 108: 3621-3622. [Full Text] [PDF]



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