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Clinical characteristics and outcomes of HIV positive patients with lymphoma in an oncological reference center in Mexico City
The epidemiology of lymphomas has changed since the use of antiretroviral therapy. The incidence of Non-Hodgkin Lymphomas (NHL) has significantly decreased in high income countries but not in low and middle-income countries where AIDS-related events remain high. This observational study describes th...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7535753/ https://www.ncbi.nlm.nih.gov/pubmed/33019417 http://dx.doi.org/10.1097/MD.0000000000022408 |
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author | Cardenas-Ortega, Andrea Ramírez-Ibarguen, Ana Florencia Rivera-Buendía, Frida Pérez-Jiménez, Carolina Volkow-Fernández, Patricia Martin-Onraet, Alexandra |
author_facet | Cardenas-Ortega, Andrea Ramírez-Ibarguen, Ana Florencia Rivera-Buendía, Frida Pérez-Jiménez, Carolina Volkow-Fernández, Patricia Martin-Onraet, Alexandra |
author_sort | Cardenas-Ortega, Andrea |
collection | PubMed |
description | The epidemiology of lymphomas has changed since the use of antiretroviral therapy. The incidence of Non-Hodgkin Lymphomas (NHL) has significantly decreased in high income countries but not in low and middle-income countries where AIDS-related events remain high. This observational study describes the characteristics, infectious complications and main outcomes of patients diagnosed with HIV and lymphoma at the Instituto Nacional de Cancerología. All adults >18 years diagnosed with HIV and lymphoma from January 2010 to December 2017 were included. Information on HIV and lymphoma was collected, as well as the occurrence of co-infections at diagnosis and during therapy. Multiple regression was done with NHL patients to evaluate independent variables associated to death. One hundred fifty three patients were included: 127 patients with NHL (83%) and 26 (17%) with Hodgkin lymphoma (HL). Of the NHL, 49 (38%) were diffuse large B cell Lymphomas (DLBCL), 35 (27%) plasmablastic, 28 (23%) Burkitt, 10 (8%) primary DLBCL of Central Nervous system, 3 (2%) T-cell lymphomas, and 2 (2%) pleural effusion lymphoma. Most patients were diagnosed in an advanced stage: 70% of NHL had a high International Prognostic Index (IPI); 68% of patients had <200 cells/mm(3). Almost 25% of NHL patients had an opportunistic infection at lymphoma diagnosis. During chemotherapy, 60% of all patients presented with at least 1 serious non-opportunistic infectious complication, and 50% presented 2 or more infectious complications, mostly bacterial infections. Thirty six percent of NHL and 23% of HL died. After adjusting for confounders, the variables associated with death were IPI and lymphoma type. HIV positive patients with lymphoma in our institution are diagnosed with an advanced stage and a high burden of infections complications. Death remains high and the variables strongly associated with death are those related to lymphoma prognosis such as lymphoma type and IPI. |
format | Online Article Text |
id | pubmed-7535753 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-75357532020-10-14 Clinical characteristics and outcomes of HIV positive patients with lymphoma in an oncological reference center in Mexico City Cardenas-Ortega, Andrea Ramírez-Ibarguen, Ana Florencia Rivera-Buendía, Frida Pérez-Jiménez, Carolina Volkow-Fernández, Patricia Martin-Onraet, Alexandra Medicine (Baltimore) 4900 The epidemiology of lymphomas has changed since the use of antiretroviral therapy. The incidence of Non-Hodgkin Lymphomas (NHL) has significantly decreased in high income countries but not in low and middle-income countries where AIDS-related events remain high. This observational study describes the characteristics, infectious complications and main outcomes of patients diagnosed with HIV and lymphoma at the Instituto Nacional de Cancerología. All adults >18 years diagnosed with HIV and lymphoma from January 2010 to December 2017 were included. Information on HIV and lymphoma was collected, as well as the occurrence of co-infections at diagnosis and during therapy. Multiple regression was done with NHL patients to evaluate independent variables associated to death. One hundred fifty three patients were included: 127 patients with NHL (83%) and 26 (17%) with Hodgkin lymphoma (HL). Of the NHL, 49 (38%) were diffuse large B cell Lymphomas (DLBCL), 35 (27%) plasmablastic, 28 (23%) Burkitt, 10 (8%) primary DLBCL of Central Nervous system, 3 (2%) T-cell lymphomas, and 2 (2%) pleural effusion lymphoma. Most patients were diagnosed in an advanced stage: 70% of NHL had a high International Prognostic Index (IPI); 68% of patients had <200 cells/mm(3). Almost 25% of NHL patients had an opportunistic infection at lymphoma diagnosis. During chemotherapy, 60% of all patients presented with at least 1 serious non-opportunistic infectious complication, and 50% presented 2 or more infectious complications, mostly bacterial infections. Thirty six percent of NHL and 23% of HL died. After adjusting for confounders, the variables associated with death were IPI and lymphoma type. HIV positive patients with lymphoma in our institution are diagnosed with an advanced stage and a high burden of infections complications. Death remains high and the variables strongly associated with death are those related to lymphoma prognosis such as lymphoma type and IPI. Lippincott Williams & Wilkins 2020-10-02 /pmc/articles/PMC7535753/ /pubmed/33019417 http://dx.doi.org/10.1097/MD.0000000000022408 Text en Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0 |
spellingShingle | 4900 Cardenas-Ortega, Andrea Ramírez-Ibarguen, Ana Florencia Rivera-Buendía, Frida Pérez-Jiménez, Carolina Volkow-Fernández, Patricia Martin-Onraet, Alexandra Clinical characteristics and outcomes of HIV positive patients with lymphoma in an oncological reference center in Mexico City |
title | Clinical characteristics and outcomes of HIV positive patients with lymphoma in an oncological reference center in Mexico City |
title_full | Clinical characteristics and outcomes of HIV positive patients with lymphoma in an oncological reference center in Mexico City |
title_fullStr | Clinical characteristics and outcomes of HIV positive patients with lymphoma in an oncological reference center in Mexico City |
title_full_unstemmed | Clinical characteristics and outcomes of HIV positive patients with lymphoma in an oncological reference center in Mexico City |
title_short | Clinical characteristics and outcomes of HIV positive patients with lymphoma in an oncological reference center in Mexico City |
title_sort | clinical characteristics and outcomes of hiv positive patients with lymphoma in an oncological reference center in mexico city |
topic | 4900 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7535753/ https://www.ncbi.nlm.nih.gov/pubmed/33019417 http://dx.doi.org/10.1097/MD.0000000000022408 |
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