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Posted by on Sep 8, 2018 in Non-Hodgkin lymphoma | 0 comments

In a nutshell

This study evaluated the outcomes of concurrent (at the same time) combination antiretroviral therapy (cART) and chemotherapy in HIV-positive patients with non-Hodgkin’s lymphoma (NHL). This study concluded that concurrent cART with chemotherapy was well-tolerated and allowed for faster immune recovery in these patients, but did not affect lymphoma outcomes.

Some background

The standard treatment for NHL is chemotherapy plus immunotherapy. However, patients who are HIV positive may not be able to tolerate this treatment. cART may be able to help these patients tolerate aggressive anti-cancer treatments without side effects that stop their treatment.

Drug interactions between cART and chemotherapy may affect disease control, or cause more side effects. Whether cART should be given or not during chemotherapy for HNL is controversial. The impact of cART given during chemotherapy on the outcomes of HIV-positive patients with NHL remains under investigation.

Methods & findings

This study compared the outcomes of cART with chemotherapy versus chemotherapy alone in HIV-positive patients with NHL. This study involved the records of 106 patients. 75.5% of patients had diffuse large B-cell lymphoma. 79.2% of patients had stage 3 – 4 disease. 70.8% of patients received cART during chemotherapy.

At 1 month after chemotherapy, more patients without cART had lower CD4 counts (a test that measures immune responses against HIV) compared to the cART group (36% vs. 19%). At 6 months after chemotherapy, CD4 counts were significantly higher in patients who received cART than those who did not (234 cells vs. 198 cells). The average HIV viral load significantly decreased in the cART group at 6 months after chemotherapy compared to the beginning of the study (75 copies per milliliter vs. 5530 copies per milliliter). 

Overall, 54.7% (cART) and 23.6% (no cART) of patients responded to chemotherapy. 40.6% (cART) and 19.8% (no cART) of patients achieved a complete response (disappearance of all signs of cancer). The 1-year survival was not significantly different between both groups (75.4% vs. 83.3%).

Concurrent cART was not significantly associated with side effects compared to chemotherapy alone. 21.7% (cART) and 9.43% (no cART) of patients reported moderate to life-threatening infections. 1.89% of patients who received cART reported numbness or tingling in their hands or feet.

The bottom line

This study concluded that concurrent cART with chemotherapy was well-tolerated and allowed for faster immune recovery in HIV-positive patients with NHL, but did not affect lymphoma outcomes.

The fine print

This study was retrospective, meaning it looked back in time to analyze data. More studies are needed to confirm these results in larger patient populations.

Published By :

Leukemia & lymphoma

Date :

Aug 01, 2018

Original Title :

Combination antiretroviral therapy accelerates immune recovery in patients with HIV-related lymphoma treated with EPOCH: a comparison within one prospective trial AMC034.

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