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Multicenter Study
. 2023 Jul 1;37(8):1217-1226.
doi: 10.1097/QAD.0000000000003549. Epub 2023 Mar 17.

Factors associated with survival in patients with lymphoma and HIV

Juliano Cordova Vargas  1   2 , Mariana de Oliveira Marques  1   3 , Juliana Pereira  4 , Walter M Tobias Braga  5 , Nelson Hamerschlak  2   6 , Jacques Tabacof  7 , Paulo Roberto Abrão Ferreira  8 , Gisele W Braga Colleoni  1 , Otavio C G Baiocchi  1   3
Affiliations
Multicenter Study

Factors associated with survival in patients with lymphoma and HIV

Juliano Cordova Vargas et al. AIDS. .

Abstract

Objective: To analyze the factors associated with survival in the largest cohort of individuals with HIV and lymphoma so far described in Brazil.

Design: A retrospective, observational, multicenter study involving five institutions in São Paulo, Brazil.

Methods: The medical records of consecutive patients with HIV diagnosed with lymphoma between January 2000 and December 2019 were screened. Inclusion criteria consisted of age over 17 years and a biopsy-confirmed diagnosis of lymphoma. The data collected included age, sex, staging (Ann Arbor system), duration of HIV infection, CD4 + lymphocyte count, HIV viral load, lactate dehydrogenase, erythrocyte sedimentation rate and serum beta-2-microglobulin levels, treatment and outcome.

Results: Overall, 276 patients were included. Median age was 42 years. Most patients were male (74.3%) and with an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 (28.6% and 46.4%, respectively). Most had non-Hodgkin lymphomas (89.2%, n = 246), particularly diffuse large B-cell lymphoma (40.9%) and Burkitt lymphoma (26.4%). Hodgkin lymphoma accounted for 9.4%. Advanced stages III/IV were predominant (86.8%). HIV viral load at the moment of lymphoma diagnosis was detectable in 52.9% of patients. A CD4 + cell count of <200 cells/μl was recorded for 53% of the patients. Most patients (62.4%) were on combination antiretroviral therapy. The factors that significantly affected survival were: the ECOG performance status, lymphoma subtype, staging, beta-2-microglobulin level, central nervous system (CNS) infiltration, site of CNS infiltration, relapsed/refractory lymphoma and International Prognostic Index score.

Conclusions: HIV status, CD4 + -lymphocyte count and relapsed/refractory disease affected survival. Rituximab did not appear to improve outcome in HIV-related lymphomas.

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