Cancers (Apr 2023)

Prognostic Factors in Children and Adolescents with Lymphomas and Vertical Transmission of HIV in Rio de Janeiro, Brazil: A Multicentric Hospital-Based Survival Analysis Study

  • Nathalia Lopez Duarte,
  • Ana Paula Silva Bueno,
  • Bárbara Sarni Sanches,
  • Gabriella Alves Ramos,
  • Julia Maria Bispo dos Santos,
  • Henrique Floriano Hess e Silva,
  • Janaina de Oliveira Pondé,
  • José Gilberto de Sá,
  • Priscila Mazucanti Rossi,
  • Patricia Regina Cavalcanti Barbosa Horn,
  • Denise Cardoso das Neves Sztajnbok,
  • Norma de Paula Motta Rubini,
  • Elaine Sobral da Costa,
  • Cristiane Bedran Milito,
  • Thalita Fernandes de Abreu,
  • Marcelo Gerardin Poirot Land

DOI
https://doi.org/10.3390/cancers15082292
Journal volume & issue
Vol. 15, no. 8
p. 2292

Abstract

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Lymphomas related to HIV are generally aggressive and have a poor prognosis, despite the use of combined antiretroviral therapy (cART) and effective chemotherapy treatment. To determine survival and prognostic factors in children and adolescents living with HIV (CLWH) in Rio de Janeiro (RJ), Brazil, who developed lymphomas, we performed a retrospective and observational study of vertically infected CLWH aged from 0 to 20 incomplete years during1995 to 2018 at five reference centers for cancer and HIV/AIDS treatment. Of the 25 lymphomas, 19 were AIDS-defining malignancies (ADM) and 6 were non-AIDS-defining malignancies (NADM). The 5-year overall survival (OS) and 5-year event-free survival (EFS) probabilities were both 32.00% (95% CI = 13.72–50.23%), and the 5-year disease-free survival (DFS) probability was 53.30% (95% CI = 28.02–78.58%). In the multivariate Cox regression analysis, performance status 4 (PS 4) was considered a poor prognostic factor for OS (HR 4.85, 95% CI = 1.81–12.97, p = 0.002) and EFS (HR 4.95, 95% CI = 1.84–13.34, p = 0.002). For the DFS, higher CD4+ T-cell counts were considered a better prognostic factor (HR 0.86, 95% CI = 0.76–0.97, p = 0.017) in the multivariate Cox regression analysis. This study demonstrates, for the first time, survival and prognostic factors for CLWH who developed lymphomas in RJ, Brazil.

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