Department of Haematology, NHLS/University of KwaZulu Natal/King Edward VIII Hospital, Durban, South Africa.
Biostatistics Research Unit, South African Medical Research Council, Durban, South Africa.
J Egypt Natl Canc Inst. 2022 Aug 1;34(1):32. doi: 10.1186/s43046-022-00131-6.
Due to the high prevalence of HIV, HIV-associated lymphoma (HAL) is a common malignancy in South Africa. However, there is a paucity of literature on HAL from this region. The objective of this study was to profile the clinical characteristics and outcome of CD20-positive HAL treated with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), with or without rituximab (R), from a single center in KwaZulu -Natal, South Africa.
Retrospective chart review of adult patients treated from 2006 to 2018 for HIV-associated CD20-positive lymphoma. The clinical characteristics, complete response (CR), and 2-year overall survival (OS) are described.
The analysis included 102 patients, 54% females, median age of 39 years, and median CD4 cell count of 196 cells/μL. Bone marrow involvement was noted in 5%. Eighty-six percent of the cohort received concomitant antiretroviral therapy and chemotherapy, 76% of the CHOP group, and 92% of the R-CHOP group. Overall, a CR was seen in 55% (95% CI 45%; 65%), with a 2-year OS of 59% (95% CI 50%, 69%). A CR was attained in 46% on CHOP and 64% on R-CHOP, with a 2-year disease-free survival (DFS) for CHOP of 42% and 50% for R-CHOP.
Although the clinical characteristics and laboratory findings are similar to other higher-income cohorts, there was a difference in gender and incidence of marrow involvement. The low incidence of marrow involvement has prompted more routine use of immunohistochemistry and flow cytometry in staging marrows of HAL locally. Further randomized studies are required for the establishment of locally validated, cost-effective treatment guidelines.
由于 HIV 的高患病率，HIV 相关淋巴瘤（HAL）是南非常见的恶性肿瘤。然而，来自该地区的 HAL 文献很少。本研究的目的是从南非夸祖鲁-纳塔尔省的一个单一中心，描述接受环磷酰胺、多柔比星、长春新碱和泼尼松（CHOP）治疗的 CD20 阳性 HAL 的临床特征和结局，以及是否联合利妥昔单抗（R）。
回顾性分析 2006 年至 2018 年期间在该中心接受治疗的 HIV 相关 CD20 阳性淋巴瘤的成年患者的病历。描述了临床特征、完全缓解（CR）和 2 年总生存率（OS）。
分析纳入了 102 例患者，其中 54%为女性，中位年龄为 39 岁，中位 CD4 细胞计数为 196 个/μL。5%的患者有骨髓受累。86%的患者同时接受抗逆转录病毒治疗和化疗，CHOP 组为 76%，R-CHOP 组为 92%。总体而言，55%（95%CI 45%；65%）的患者达到了 CR，2 年 OS 为 59%（95%CI 50%，69%）。CHOP 组的 CR 为 46%，R-CHOP 组的 CR 为 64%，CHOP 组的 2 年无病生存率（DFS）为 42%，R-CHOP 组为 50%。
尽管临床特征和实验室检查结果与其他高收入队列相似，但在性别和骨髓受累发生率方面存在差异。骨髓受累发生率低促使当地更常规地使用免疫组织化学和流式细胞术来分期 HAL 骨髓。需要进一步进行随机研究，以制定经过验证的、具有成本效益的当地治疗指南。
