Incidence and risk factors for relapses in HIV-associated non-Hodgkin lymphoma as observed in the German HIV-related lymphoma cohort study
Philipp Schommers,
Daniel Gillor,
Marcus Hentrich,
Christoph Wyen,
Timo Wolf,
Mark Oette,
Alexander Zoufaly,
Jan-Christian Wasmuth,
Johannes R. Bogner,
Markus Müller,
Stefan Esser,
Alisa Schleicher,
Björn Jensen,
Albrecht Stoehr,
Georg Behrens,
Alexander Schultze,
Jan Siehl,
Jan Thoden,
Ninon Taylor,
Christian Hoffmann
Affiliations
Philipp Schommers
Department I of Internal Medicine, University Hospital Cologne, Germany;German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Germany
Daniel Gillor
Department I of Internal Medicine, University Hospital Cologne, Germany
Marcus Hentrich
Department of Medicine III, Red Cross Hospital Munich, Germany
Christoph Wyen
Department I of Internal Medicine, University Hospital Cologne, Germany;Praxis am Ebertplatz, Cologne, Germany
Timo Wolf
Department of Medicine II, University of Frankfurt, Germany
Mark Oette
Department of General Medicine, Gastroenterology and Infectious Diseases, Augustinerinnen Hospital, Cologne, Germany
Alexander Zoufaly
Department of Medicine IV, Kaiser Franz Josef Hospital, Vienna, Austria
Jan-Christian Wasmuth
Department of Internal Medicine I, University of Bonn, Germany
Johannes R. Bogner
Department of Medicine IV, University of Munich, Munich, Germany
Markus Müller
Department of Infectious Diseases, Vivantes Auguste-Viktoria-Hospital, Berlin, Germany
Stefan Esser
Department of Dermatology, University Hospital Essen, Germany
Alisa Schleicher
University of Schleswig Holstein, Campus Kiel, Kiel, Germany
Björn Jensen
Department of Gastroenterology, Hepatology and Infectious Diseases, Düsseldorf University Hospital, Germany
Albrecht Stoehr
Ifi-Institute for Interdisciplinary Medicine, Hamburg, Germany
Georg Behrens
Department of Clinical Immunology and Rheumatology, Hannover Medical School, Germany;German Center for Infection Research (DZIF), Hannover, Germany
Alexander Schultze
Department of Emergency Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Jan Siehl
Ärzteforum Seestraße, Berlin, Germany
Jan Thoden
Medical Group Practice for Internal Medicine and Rheumatology, Freiburg, Germany
Ninon Taylor
Department of Internal Medicine III with Hematology, Medical Oncology, Hemostaseology, Infectious Diseases, Rheumatology, Oncologic Center, Laboratory of Immunological and Molecular Cancer Research, Paracelsus Medical University Salzburg, Austria
Christian Hoffmann
University of Schleswig Holstein, Campus Kiel, Kiel, Germany;IPM Study Center, Hamburg, Germany
Outcome of HIV-infected patients with AIDS-related lymphomas has improved during recent years. However, data on incidence, risk factors, and outcome of relapses in AIDS-related lymphomas after achieving complete remission are still limited. This prospective observational multicenter study includes HIV-infected patients with biopsy- or cytology-proven malignant lymphomas since 2005. Data on HIV infection and lymphoma characteristics, treatment and outcome were recorded. For this analysis, AIDS-related lymphomas patients in complete remission were analyzed in terms of their relapse- free survival and potential risk factors for relapses. In total, 254 of 399 (63.7%) patients with AIDS-related lymphomas reached a complete remission with their first-line chemotherapy. After a median follow up of 4.6 years, 5-year overall survival of the 254 patients was 87.8% (Standard Error 3.1%). Twenty-nine patients relapsed (11.4%). Several factors were independently associated with a higher relapse rate, including an unclassifiable histology, a stage III or IV according to the Ann Arbor Staging System, no concomitant combined antiretroviral therapy during chemotherapy and R-CHOP-based compared to more intensive chemotherapy regimens in Burkitt lymphomas. In conclusion, complete remission and relapse rates observed in our study are similar to those reported in HIV-negative non-Hodgkin lymphomas. These data provide further evidence for the use of concomitant combined antiretroviral therapy during chemotherapy and a benefit from more intensive chemotherapy regimens in Burkitt lymphomas. Modifications to the chemotherapy regimen appear to have only a limited impact on relapse rate.