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Session 100 Poster Presentations
HIV/AIDS-Related Lymphoma
Session Day and Time: Wednesday 1:30 - 3:30 pm
Room: Hall B


802
Characteristics and Outcome of AIDS-related Non-Hodgkin’s Lymphoma Before and After the Introduction of HAART (GESIDA 23/01)
P. Miralles1, J. Berenguer*1, R. Rubio2, J. M. Ribera3, A. Antela4, J. Santos5, J. Baraia6, E. Valencia7, F. R. - Arrondo8, J. L. - Aldeguer9, P. Domingo10, E. Ribera11, J. De la Torre12, J. R. Arribas13, 23/01 study group14
1Hosp G Marañón, Madrid; 2Hosp 12 de Oct, Madrid, Spain; 3Hosp T y Pujol, Barcelona, Spain; 4Hosp Ramón y Cajal, Madrid, Spain; 5Hosp V Victoria, Málaga, Spain; 6Hosp Basurto, Bilbao; 7Hosp Carlos III, Madrid, Spain; 8Hosp Aránzazu, San Sebastian, Spain; 9Hosp La Fé, Valencia; 10Hosp St Pau, Barcelona, Spain; 11Hosp V Hebrón, Barcelona, Spain; 12Hosp R Sofía, Córdoba, Spain; 13Hosp La Paz, Madrid, Spain; and 14Grupo de Estudio del SIDA (GESIDA), Madrid, Spain

Background:    We analyzed survival, therapeutic response and prognostic factors in patients (pPts) with AIDS-related non-Hodgkin’s lymphoma (AIDS-related Non-Hodgkin’s Lymphoma (ARL) ARL) before and after the introduction of HAART.

Methods:    Study period: January 94 to June 01. Patients: 332 consecutive Pt  pts with ARL from 18 centers in Spain; 198 were treated with HAART before, during or immediately after the treatment of ARL = HAART (+) and 134 did not fulfill the prior requisites = HAART (-). Outcome variables: Survival and complete remission (CR).

Results:    Significant differences were found in the following baseline characteristics among HAART (-) and HAART (+) groups: Median age was 34 yrs vs 38 yyrs (p = 0.001), female sex 15% vs 24% (p = 0.047), prior AIDS 56% vs 42% (p = 0.01), median CD4 cell count 73 vs 147 (p < 0.001), International Prognostic Index (IPI) 3%-–5 55% vs 38% (p = 0.04), marrow involvement 38% vs 27% (p = 0.035) and CNS involvement 27% vs 11% (p = 0.005). Differences were not found in transmission group categories and REAL histology subtypes. The following differences were found in the treatment of ARL among HAART (-) and HAART (+) groups: chemotherapy 76% vs 93% (p = 0.001), reduced doses of cytotoxic drugs 37% vs 23% (p = 0.017) and CNS prophylaxis 27% vs 43% (p = 0.004). In an intention-to-treat (ITT) analysis (Pt patients with ≥ 1 chemotherapy course), the median survival after ARL for HAART (-) and HAART (+) was 5 mos vs 50 mos, p < 0.0001. By ITT, the CR for HAART (-) and HAART (+) were 26% vs 68%, p < 0.001. By multivariate analysis, HAART and IPI were significantly associated with overall survival and with CR. In comparison with the HAART (+) group, the adjusted HR HR (95% CI) of death was 2.26 (1.54 – 3.31) in the HAART (-) group. In comparison with IPI 0-1, the adjusted HR HR  of death was 2.49 (1.40 - –4.42) for IPI 2, 3.77 (2.08 – 6.84) for IPI 3 and 5.63 (3.24 – 9.79) for IPI 4-5 (Cox regression analysis). In comparison with the HAART (+) group, the adjusted OR OR (95% CI) of not achieving CR was 6.72 (3.23–13.9) in the HAART (-) group. In comparison with IPI 0-–1, the adjusted OR OR (95% CI) of not achieving CR was 3.24 (1.38 – 7.58) for IPI 2, 4.68 (1.78–12.26) for IPI 3 and 9.68 (3.86–24.28) for IPI 4-5 (logistic-regression analysis).

Conclusions:    We found that HAART significantly improved both survival and CR in Ptpts  patients with ARL. We also found that in the HAART (+) group Pt ptspatients were older, more frequently female, had higher CD4 cell counts, and had ARL with better prognostic factors (IPI). More Ptpts patients in the HAART (+) group received chemotherapy, CNS prophylaxis and full-doses of cytotoxic drugs.