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Outcomes of treatment with CHOP and EPOCH in patients with HIV associated NHL in a low resource setting
BACKGROUND: The optimal chemotherapy regimen for treating HIV associated NHL in low resource settings is unknown. We conducted a retrospective study to describe survival rates, treatment response rates and adverse events in patients with HIV associated NHL treated with CHOP and dose adjusted-EPOCH r...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7446121/ https://www.ncbi.nlm.nih.gov/pubmed/32831073 http://dx.doi.org/10.1186/s12885-020-07305-2 |
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author | Okello, Clement D. Omoding, Abrahams Ddungu, Henry Mulumba, Yusuf Orem, Jackson |
author_facet | Okello, Clement D. Omoding, Abrahams Ddungu, Henry Mulumba, Yusuf Orem, Jackson |
author_sort | Okello, Clement D. |
collection | PubMed |
description | BACKGROUND: The optimal chemotherapy regimen for treating HIV associated NHL in low resource settings is unknown. We conducted a retrospective study to describe survival rates, treatment response rates and adverse events in patients with HIV associated NHL treated with CHOP and dose adjusted-EPOCH regimens at the Uganda Cancer Institute. METHODS: A retrospective study of patients diagnosed with HIV and lymphoma and treated at the Uganda Cancer Institute from 2016 to 2018 was done. RESULTS: One hundred eight patients treated with CHOP and 12 patients treated with DA-EPOCH were analysed. Patients completing 6 or more cycles of chemotherapy were 51 (47%) in the CHOP group and 8 (67%) in the DA-EPOCH group. One year overall survival (OS) rate in patients treated with CHOP was 54.5% (95% CI, 42.8–64.8) and 80.2% (95% CI, 40.3–94.8) in those treated with DA-EPOCH. Factors associated with favourable survival were BMI 18.5–24.9 kg/m(2), (p = 0.03) and completion of 6 or more cycles of chemotherapy, (p < 0.001). The overall response rate was 40% in the CHOP group and 59% in the DA-EPOCH group. Severe adverse events occurred in 19 (18%) patients in the CHOP group and 3 (25%) in the DA-EPOCH group; these were neutropenia (CHOP = 13, 12%; DA-EPOCH = 2, 17%), anaemia (CHOP = 12, 12%; DA-EPOCH = 1, 8%), thrombocytopenia (CHOP = 7, 6%; DA-EPOCH = 0), sepsis (CHOP = 1), treatment related death (DA-EPOCH = 1) and hepatic encephalopathy (CHOP = 1). CONCLUSION: Treatment of HIV associated NHL with curative intent using CHOP and infusional DA-EPOCH is feasible in low resource settings and associated with > 50% 1 year survival. |
format | Online Article Text |
id | pubmed-7446121 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-74461212020-08-26 Outcomes of treatment with CHOP and EPOCH in patients with HIV associated NHL in a low resource setting Okello, Clement D. Omoding, Abrahams Ddungu, Henry Mulumba, Yusuf Orem, Jackson BMC Cancer Research Article BACKGROUND: The optimal chemotherapy regimen for treating HIV associated NHL in low resource settings is unknown. We conducted a retrospective study to describe survival rates, treatment response rates and adverse events in patients with HIV associated NHL treated with CHOP and dose adjusted-EPOCH regimens at the Uganda Cancer Institute. METHODS: A retrospective study of patients diagnosed with HIV and lymphoma and treated at the Uganda Cancer Institute from 2016 to 2018 was done. RESULTS: One hundred eight patients treated with CHOP and 12 patients treated with DA-EPOCH were analysed. Patients completing 6 or more cycles of chemotherapy were 51 (47%) in the CHOP group and 8 (67%) in the DA-EPOCH group. One year overall survival (OS) rate in patients treated with CHOP was 54.5% (95% CI, 42.8–64.8) and 80.2% (95% CI, 40.3–94.8) in those treated with DA-EPOCH. Factors associated with favourable survival were BMI 18.5–24.9 kg/m(2), (p = 0.03) and completion of 6 or more cycles of chemotherapy, (p < 0.001). The overall response rate was 40% in the CHOP group and 59% in the DA-EPOCH group. Severe adverse events occurred in 19 (18%) patients in the CHOP group and 3 (25%) in the DA-EPOCH group; these were neutropenia (CHOP = 13, 12%; DA-EPOCH = 2, 17%), anaemia (CHOP = 12, 12%; DA-EPOCH = 1, 8%), thrombocytopenia (CHOP = 7, 6%; DA-EPOCH = 0), sepsis (CHOP = 1), treatment related death (DA-EPOCH = 1) and hepatic encephalopathy (CHOP = 1). CONCLUSION: Treatment of HIV associated NHL with curative intent using CHOP and infusional DA-EPOCH is feasible in low resource settings and associated with > 50% 1 year survival. BioMed Central 2020-08-24 /pmc/articles/PMC7446121/ /pubmed/32831073 http://dx.doi.org/10.1186/s12885-020-07305-2 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Okello, Clement D. Omoding, Abrahams Ddungu, Henry Mulumba, Yusuf Orem, Jackson Outcomes of treatment with CHOP and EPOCH in patients with HIV associated NHL in a low resource setting |
title | Outcomes of treatment with CHOP and EPOCH in patients with HIV associated NHL in a low resource setting |
title_full | Outcomes of treatment with CHOP and EPOCH in patients with HIV associated NHL in a low resource setting |
title_fullStr | Outcomes of treatment with CHOP and EPOCH in patients with HIV associated NHL in a low resource setting |
title_full_unstemmed | Outcomes of treatment with CHOP and EPOCH in patients with HIV associated NHL in a low resource setting |
title_short | Outcomes of treatment with CHOP and EPOCH in patients with HIV associated NHL in a low resource setting |
title_sort | outcomes of treatment with chop and epoch in patients with hiv associated nhl in a low resource setting |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7446121/ https://www.ncbi.nlm.nih.gov/pubmed/32831073 http://dx.doi.org/10.1186/s12885-020-07305-2 |
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