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1489. CD4+ T Cell Count and Associated Mortality in PLWHIV and Cancer at an Oncologic Center in Mexico over a 10-year Period.
BACKGROUND: PLWHIV and cancer have an increased risk of mortality. Previous studies show that a 100 cells/mm(3) drop in CD4+ T cells following chemotherapy increases the risk of mortality by up to 30%. In Mexico almost 40% of patients have a late diagnosis. The aim of this study is to measure the mo...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10678980/ http://dx.doi.org/10.1093/ofid/ofad500.1324 |
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author | Olmedo-Reneaum, Alejandro VOLKOW-FERNÁNDEZ, P A T R I C I A MARTÍNEZ-RIVERA, N A N C Y MENDOZA-PALACIOS, M A R ÍA J O S É ISLAS-MUÑOZ, B E D A |
author_facet | Olmedo-Reneaum, Alejandro VOLKOW-FERNÁNDEZ, P A T R I C I A MARTÍNEZ-RIVERA, N A N C Y MENDOZA-PALACIOS, M A R ÍA J O S É ISLAS-MUÑOZ, B E D A |
author_sort | Olmedo-Reneaum, Alejandro |
collection | PubMed |
description | BACKGROUND: PLWHIV and cancer have an increased risk of mortality. Previous studies show that a 100 cells/mm(3) drop in CD4+ T cells following chemotherapy increases the risk of mortality by up to 30%. In Mexico almost 40% of patients have a late diagnosis. The aim of this study is to measure the mortality association between the CD4+ T cell count nadir in PLWHIV and cancer. METHODS: We conducted a retrospective study involving PLWHIV and cancer ≥18 yo treated at the cancer and AIDS clinic of the Instituto Nacional de Cancerología in México City from January 01, 2005, to December 31, 2015, that received chemotherapy, immunotherapy, radiotherapy and/or oncologic surgery. The baseline CD4+ T cell count, nadir during treatment, first CD4+ T cell count after treatment, one year and five years after the end of oncologic treatment were evaluated. A logistic regression (LR) model was performed considering CD4+ T cell count at baseline, nadir during oncologic treatment and the association with all-cause mortality. Institutional Review Board (IRB) of INCan approved the study (Ref/INCAN/CI/0049/2022). RESULTS: A total of 445 patients were included, median of nadir CD4+ T cell count was 122 cells/µL (IQR 48-232), 147 (32.89%) had baseline CD4+ T cell ≤100 cells/µL. Kaposi Sarcoma (46%) and non-Hodgkin lymphoma (27%) were the most frequent diagnosis. One-year mortality occurred in 72 patients (16%), from them, the cause of death was cancer in 54 (75%). Descriptive analysis by mean difference showed significant difference in CD4+ T cell count between patients who died vs. those who survived 117.7 vs 175.4 (p=0.01). In the LR model, a significant association was found between stage IV of cancer and higher mortality at 1 year (OR 2.39; CI 1.27- 4.52) and at 5 years (OR 2.21; CI 1.21-4.02). At five years, mortality was higher in patients with a second AIDS defining event (OR 2.17; CI 1.12-4.17). At one year after completed cancer treatment having a CD4+ T cell nadir >200 cells/ µL was associated with lower mortality (OR 0.29; CI 0.08 – 0.92). CONCLUSION: This study found that having other AIDS defining events and advanced neoplastic disease was associated with higher mortality; while having a nadir ≥200 cd4+ cells/ml showed lower mortality after one year of treatment. DISCLOSURES: All Authors: No reported disclosures |
format | Online Article Text |
id | pubmed-10678980 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-106789802023-11-27 1489. CD4+ T Cell Count and Associated Mortality in PLWHIV and Cancer at an Oncologic Center in Mexico over a 10-year Period. Olmedo-Reneaum, Alejandro VOLKOW-FERNÁNDEZ, P A T R I C I A MARTÍNEZ-RIVERA, N A N C Y MENDOZA-PALACIOS, M A R ÍA J O S É ISLAS-MUÑOZ, B E D A Open Forum Infect Dis Abstract BACKGROUND: PLWHIV and cancer have an increased risk of mortality. Previous studies show that a 100 cells/mm(3) drop in CD4+ T cells following chemotherapy increases the risk of mortality by up to 30%. In Mexico almost 40% of patients have a late diagnosis. The aim of this study is to measure the mortality association between the CD4+ T cell count nadir in PLWHIV and cancer. METHODS: We conducted a retrospective study involving PLWHIV and cancer ≥18 yo treated at the cancer and AIDS clinic of the Instituto Nacional de Cancerología in México City from January 01, 2005, to December 31, 2015, that received chemotherapy, immunotherapy, radiotherapy and/or oncologic surgery. The baseline CD4+ T cell count, nadir during treatment, first CD4+ T cell count after treatment, one year and five years after the end of oncologic treatment were evaluated. A logistic regression (LR) model was performed considering CD4+ T cell count at baseline, nadir during oncologic treatment and the association with all-cause mortality. Institutional Review Board (IRB) of INCan approved the study (Ref/INCAN/CI/0049/2022). RESULTS: A total of 445 patients were included, median of nadir CD4+ T cell count was 122 cells/µL (IQR 48-232), 147 (32.89%) had baseline CD4+ T cell ≤100 cells/µL. Kaposi Sarcoma (46%) and non-Hodgkin lymphoma (27%) were the most frequent diagnosis. One-year mortality occurred in 72 patients (16%), from them, the cause of death was cancer in 54 (75%). Descriptive analysis by mean difference showed significant difference in CD4+ T cell count between patients who died vs. those who survived 117.7 vs 175.4 (p=0.01). In the LR model, a significant association was found between stage IV of cancer and higher mortality at 1 year (OR 2.39; CI 1.27- 4.52) and at 5 years (OR 2.21; CI 1.21-4.02). At five years, mortality was higher in patients with a second AIDS defining event (OR 2.17; CI 1.12-4.17). At one year after completed cancer treatment having a CD4+ T cell nadir >200 cells/ µL was associated with lower mortality (OR 0.29; CI 0.08 – 0.92). CONCLUSION: This study found that having other AIDS defining events and advanced neoplastic disease was associated with higher mortality; while having a nadir ≥200 cd4+ cells/ml showed lower mortality after one year of treatment. DISCLOSURES: All Authors: No reported disclosures Oxford University Press 2023-11-27 /pmc/articles/PMC10678980/ http://dx.doi.org/10.1093/ofid/ofad500.1324 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Abstract Olmedo-Reneaum, Alejandro VOLKOW-FERNÁNDEZ, P A T R I C I A MARTÍNEZ-RIVERA, N A N C Y MENDOZA-PALACIOS, M A R ÍA J O S É ISLAS-MUÑOZ, B E D A 1489. CD4+ T Cell Count and Associated Mortality in PLWHIV and Cancer at an Oncologic Center in Mexico over a 10-year Period. |
title | 1489. CD4+ T Cell Count and Associated Mortality in PLWHIV and Cancer at an Oncologic Center in Mexico over a 10-year Period. |
title_full | 1489. CD4+ T Cell Count and Associated Mortality in PLWHIV and Cancer at an Oncologic Center in Mexico over a 10-year Period. |
title_fullStr | 1489. CD4+ T Cell Count and Associated Mortality in PLWHIV and Cancer at an Oncologic Center in Mexico over a 10-year Period. |
title_full_unstemmed | 1489. CD4+ T Cell Count and Associated Mortality in PLWHIV and Cancer at an Oncologic Center in Mexico over a 10-year Period. |
title_short | 1489. CD4+ T Cell Count and Associated Mortality in PLWHIV and Cancer at an Oncologic Center in Mexico over a 10-year Period. |
title_sort | 1489. cd4+ t cell count and associated mortality in plwhiv and cancer at an oncologic center in mexico over a 10-year period. |
topic | Abstract |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10678980/ http://dx.doi.org/10.1093/ofid/ofad500.1324 |
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