- 133: Blood. 2006 Jan 12
AIDS-related non-Hodgkin's lymphoma: final analysis of 485 patients treated with risk-adapted intensive chemotherapy.
Mounier N, Spina M, Gabarre J, Raphael M, Rizzardini G, Golfier JB, Vaccher E, Carbone A, Coiffier B, Chichino G, Bosly A, Tirelli U, Gisselbrecht C.
Groupe d'Etude des Lymphomes - GELA, Paris, France.
We aimed to compare AIDS risk-adapted intensive chemotherapy in AIDS-related lymphoma patients before and after the advent of highly active antiretroviral therapy (HAART). 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-positive cell counts < 100/mm(3). 218 good risk patients (HIV score 0) received ACVBP or CHOP, 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=0.85), in the intermediate risk group, 28% for CHOP versus 24% for Ld-CHOP (p=0.19), and in the poor risk group, 11% for Ld-CHOP versus 3% for VS (p=0.14). The time-dependent Cox model demonstrated that the only significant factors for OS were HAART (RR 1.6, p=0.0002), HIV score (RR 1.7, p=0.0001) and the International Prognostic Index (IPI) score (RR 1.5, p=0.0012) 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.