Impact of initial chemotherapy cycles and clinical characteristics on outcomes for HIV-associated diffuse large B cell lymphoma patients: The Central and Western China AIDS Lymphoma League 001 study (CALL-001 study)

作者全名："Wang, Chaoyu; Wu, Yan; Liu, Jun; Min, Haiyan; Huang, Yunhong; Wei, Guo; Zhang, Wei; Wang, Min; Tang, Xiaoqiong; Zhou, Hui; Chen, Yaokai; Liu, Yao"

作者地址："[Wang, Chaoyu; Liu, Jun; Liu, Yao] Chongqing Univ, Dept Hematol Oncol, Chongqing Key Lab Translat Res Canc Metastasis & I, Canc Hosp, Chongqing, Peoples R China; [Wu, Yan] Sixth Peoples Hosp Zhengzhou, Henan Infect Dis Hosp, Zhengzhou, Henan, Peoples R China; [Liu, Jun] Kunming Third Peoples Hosp, Dept Hematol, Kunming, Yunnan, Peoples R China; [Min, Haiyan] Yunnan Prov Hosp Infect Dis, Infect Dis Dept, Kunming, Yunnan, Peoples R China; [Huang, Yunhong] Guizhou Med Univ, Affiliated Hosp, Guiyang, Guizhou, Peoples R China; [Wei, Guo] Publ Hlth Clin Ctr Chengdu, Oncol Surg, Chengdu, Sichuan, Peoples R China; [Zhang, Wei] Chinese Acad Med Sci CAMS & Peking Union Med Coll, Peking Union Med Coll Hosp, Beijing, Peoples R China; [Wang, Min] First Hosp Changsha, Dept Infect & Immunol, Changsha, Hunan, Peoples R China; [Tang, Xiaoqiong] Chongqing Med Univ, Affiliated Hosp 1, Chongqing, Peoples R China; [Zhou, Hui] Cent South Univ, Affiliated Tumor Hosp, Xiangya Med Sch, Changsha, Hunan, Peoples R China; [Chen, Yaokai] Chongqing Publ Hlth Med Ctr, Dept Infect Med, Chongqing, Peoples R China"

通信作者："Liu, Y (通讯作者)，Chongqing Univ, Dept Hematol Oncol, Chongqing Key Lab Translat Res Canc Metastasis & I, Canc Hosp, Chongqing, Peoples R China.; Zhou, H (通讯作者)，Cent South Univ, Affiliated Tumor Hosp, Xiangya Med Sch, Changsha, Hunan, Peoples R China.; Chen, YK (通讯作者)，Chongqing Publ Hlth Med Ctr, Dept Infect Med, Chongqing, Peoples R China."

来源：FRONTIERS IN IMMUNOLOGY

ESI学科分类：IMMUNOLOGY

WOS号：WOS:000967479800001

JCR分区：Q1

影响因子：5.7

年份：2023

卷号：14

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：HIV; DLBCL; prognosis; chemotherapy cycles; CALL

摘要："IntroductionLittle is known about the first line induction chemotherapy cycles for HIV-associated diffuse large B-cell lymphoma (DLBCL) as these are less common than HIV-negative lymphoma. Currently, the optimal treatment cycles option remains undefined. Therefore, we performed a multi-center study to analyze the clinical characteristics and outcomes of HIV-associated DLBCL patients in different treatment modes in China. MethodsTotally 273 newly diagnosed HIV-associated DLBCL patients at eleven large academic centers from October 2008 to October 2021, were analyzed. ResultsIn the entire cohort, the median age was 47 years (range, 21-90) at lymphoma diagnosis, and 223 patients were male (81.7%). One hundred and ninety-four (71.1%) patients were germinal center B-cell-like lymphoma (GCB) subtype. Most patients (65.2%, 178/273) had elevated lactate dehydrogenase (LDH), and advanced Ann Arbor stage (78.9% 213/273) at diagnosis. High international prognostic index (IPI) score (3-5) at diagnosis was found in 65.2% (178/273) of patients. One hundred and fifty-five patients (56.8%) had extranodal involvement. The median CD4 cell count was 168/mu l (range, 2-1067), of whom 174 (63.7%) had a CD4 cell count below 200/mu l. The median follow-up of our cohort was 10.1 (0.1-160) months. The overall 2-year OS rates 58.0%. Median OS times in the 0, 1-3, 4-6, and >6 cycles chemotherapy cohort were 7.1 months, 20.0 months, not reached, and not reached, respectively (Hazard Ratio (HR)=0.549, 95% Confidence interval (CI) 0.451-0.667; p<0.001). Cox multivariate analysis showed that age >= 60 (HR=2.207, 95%CI 1.321-3.690; p=0.003), high IPI score (3-5) (HR=2.926, 95% CI 1.716-4.988; p<0.001), B symptoms (HR=1.928, 95%CI 1.192-3.119; p=0.007), elevated LDH (HR=1.696, 95%CI 1.031-2.791; p=0.038) and received less than 4 cycles chemotherapy (HR=0.520, 95%CI 0.424-0.637; p<0.001) were independent risk factor for adverse prognosis based on overall survival (OS). DiscussionThese results demonstrated that 4-6 cycles chemotherapy were significantly associated with improved outcomes in HIV-associated DLBCL patients. However, >6 cycles chemotherapy did not further improve the survival of patients."

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