Predictors of survival after a diagnosis of non-Hodgkin lymphoma in a resource-limited setting: a retrospective study on the impact of HIV infection and its treatment
- PMID: 21350364
- PMCID: PMC3065203
- DOI: 10.1097/QAI.0b013e31820c011a
Predictors of survival after a diagnosis of non-Hodgkin lymphoma in a resource-limited setting: a retrospective study on the impact of HIV infection and its treatment
Abstract
Objective: We examined factors associated with survival among patients with newly diagnosed non-Hodgkin lymphoma (NHL) in Uganda.
Methods: Information was abstracted from medical records for all NHL patients >13 years of age at the Uganda Cancer Institute between January 2004 and August 2008. Cox proportional hazard models were used to identify predictors of NHL survival.
Results: One hundred sixty patients with NHL were identified; 51 (31.9%) were known to be HIV positive. Overall, 154 patients had records sufficient for further analysis. The median person-time observed was 104 days (interquartile range 26-222). Median survival after presentation among those whose mortality status was confirmed was 61 days (interquartile range 25-203). HIV-positive patients receiving antiretroviral therapy had survival rates approximating those of HIV-negative persons, but the adjusted hazard of death was significantly elevated among HIV-positive patients not receiving antiretroviral therapy [adjusted hazard ratio (HR) 8.99, P < 0.001] compared with HIV-negative patients. Both B-symptoms (HR 2.08, P = 0.05) and female gender (HR 1.72, P = 0.05) were associated with higher mortality.
Conclusions: In Uganda, overall survival of NHL patients is poor, and predictors of survival differed from those described in resource-rich regions. HIV is a common comorbidity to NHL, and its lack of treatment was among the strongest predictors of mortality. Strategies are needed for optimal management of HIV-infected individuals with cancer in resource-limited settings.
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Comment in
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Cancer in resource-limited settings.J Acquir Immune Defic Syndr. 2011 Apr;56(4):297-9. doi: 10.1097/QAI.0b013e31820c0b0f. J Acquir Immune Defic Syndr. 2011. PMID: 21350363 No abstract available.
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