Outcome of patients with relapsed/refractory acquired immune deficiency syndrome-related lymphoma diagnosed 19992008 and treated with curative intent in the AIDS Malignancy Consortium

Ulas D. Bayraktar, Juan Carlos Ramos, Adam Petrich, Neel Gupta, Shelly Lensing, P. C. Moore, Erin G. Reid, David M. Aboulafia, Lee Ratner, Ronald Mitsuyasu, Timothy Cooley, David H. Henry, Paul Barr, Ariela Noy

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18 Scopus citations

Abstract

No comparative studies exist for relapsed/refractory (rel/rfr) acquired immune deficiency syndrome (AIDS)-related lymphoma (ARL). To determine practices over the last decade and to assess the outcomes of salvage chemotherapy with curative intent and autologous stem cell transplant (ASCT), we retrospectively evaluated treatment outcomes in patients with rel/rfr ARL who were treated in 13 national AIDS Malignancy Consortium (AMC) sites between 1999 and 2008 (n 88). The most commonly used second-line therapies were ICE (ifosfamide/carboplatin/ etoposide, n 34), dose adjusted EPOCH (etoposide/prednisone/vincristine/ cyclophosphamide/doxorubicin, n 17) and ESHAP (etoposide/methylprednisolone/ cytarabine/cisplatin, n 11). The odds of achieving a response were lower for those with non-Hodgkin lymphoma (NHL) than for those with HL and for those with primary refractory disease than for those with relapse. Overall survival (OS) was significantly longer for those with relapsed disease compared to those with refractory disease and for those with non-Burkitt NHL compared to those with Burkitt. OS was longer in patients who underwent ASCT compared to those who did not (1-year OS: 63.2% vs. 37.2%). However, among 32 patients (36%) who achieved a complete or partial reponse (CR/PR) after second-line therapy, 1-year OS was not different between the two groups (87.5% for ASCT vs. 81.8% for non-ASCT). Long-term survival in some patients with rel/rfr ARL may be possible without transplant, although transplant remains the standard of care for chemotherapy sensitive disease.

Original languageEnglish (US)
Pages (from-to)2383-2389
Number of pages7
JournalLeukemia and Lymphoma
Volume53
Issue number12
DOIs
StatePublished - Dec 1 2012

Keywords

  • Acquired immune deficiency syndrome
  • Lymphoma
  • Salvage therapy
  • Stem cell transplant

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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    Bayraktar, U. D., Ramos, J. C., Petrich, A., Gupta, N., Lensing, S., Moore, P. C., Reid, E. G., Aboulafia, D. M., Ratner, L., Mitsuyasu, R., Cooley, T., Henry, D. H., Barr, P., & Noy, A. (2012). Outcome of patients with relapsed/refractory acquired immune deficiency syndrome-related lymphoma diagnosed 19992008 and treated with curative intent in the AIDS Malignancy Consortium. Leukemia and Lymphoma, 53(12), 2383-2389. https://doi.org/10.3109/10428194.2012.697559