Erschienen in:
21.04.2023 | Original Article
A Retrospective Cohort Study to Evaluate the Outcomes of HIV-Associated High-Grade B-Cell Non-Hodgkin Lymphoma (NHL) Treated with Dose Adjusted EPOCH (+/−R) Regimen
verfasst von:
Jayashree Thorat, Manju Sengar, Raajit Chanana, Akhil Kapoor, Ajay Singh, Avinash Bonda, Hari Menon, Bhausaheb Bagal, Siddharth Laskar, Nehal Khanna, Jayant Shastri Goda, Epari Sridhar, Sumeet Gujral, Archi Agarwal, Sheela Sawant, Anuprita Daddi, Tanuja Shet, Netra Ghandade, Hasmukh Jain
Erschienen in:
Indian Journal of Hematology and Blood Transfusion
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Ausgabe 1/2024
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Abstract
High-grade B-cell NHL’s are more common in seropositive patients. They are biologically different from their seronegative counterparts. We report our analysis on our cohort of patients who were treated with DA-EPOCH(+/−R). We retrospectively analyzed treatment-naïve HIV-associated High-grade B-cell NHL patients (aged ≥ 18) treated with DA-EPOCH(+/−R) regimen from 2011 to 2015. Descriptive statistics were summarized with median and range; survival outcomes were analyzed with Kaplan–Meier method. The cohort comprised of 40 patients [DLBCL(19), Burkitt’s Lymphoma(16), High-grade B-Cell Lymphoma-Unclassifiable(09), and Plasmablastic Lymphoma(01)] and the median CD4 + T cell count was 202/mm3. CNS prophylaxis was administered with intrathecal methotrexate to 90% of patients. With a median follow-up of 72 months, an estimated 5-year OS was 82.5%, and 5-PFS was 77.5%. There were 9 deaths, and 9 patients had progression. At least 4 cycles of chemotherapy were administered to 35 (93%) patients, with 28 (70%) receiving 6 cycles. Grade 3–4 toxicities were seen in 33 (83%) patients- febrile neutropenia (65%) being the most common followed by mucositis (25%) and peripheral neuropathy (13%). There was no difference in survival based on IPI, CD 4 + T cell count, CDI, or duration of HIV. DA-EPOCH(+/−R) is a highly effective regimen in seropositive high-grade B-cell lymphoma, even in the presence of adverse features.