Survival Rates Among Patients With DLBCL, HIV Treated With Radiotherapy

According to a study in Reports of Practical Oncology & Radiotherapy that examined radiotherapy response differences among HIV positive (HIV +) patients who were also diagnosed with diffuse large B-cell lymphoma (DLBCL), researchers found radiotherapy did not impact survival or progression in their limited sample.

“Current guidelines tend to treat HIV+ patients as their seronegative counterparts with DLBCL but little is known about their radiotherapy responses differences,” researchers wrote.

To better understand treatment differences, the research team conducted a retrospective cohort study. They examined HIV + DBCL patients treated with chemotherapy between 2004 and 2018, and all participants had biopsy-proven lymphomas.

“They were included if the proposed radical treatment was done without progression or death during chemotherapy and had at least 6 months of follow-up or were followed until death,” they noted.

Based on the criteria, the researchers identified 53 patients with a median age of 41.39 years (20-65 years) at diagnosis. More specifically, 54.7% were male, and most participants had a good performance in the ECOG scale at diagnoses (81.1% are ECOG 0-1).

According to the findings, median overall survival was not reached. Some of the findings showed:

• mean overall survival was 41.5 months;
• there were 16 deaths observed;
• patients over 60 years were more at risk (P = .044), which helped identify age as a factor; and
• longtime use of highly active antiretroviral therapy impacted overall survival, which put those that started antiretroviral therapy within the diagnose of the lymphoma at greatest risk (P = .044).

Most importantly, the researchers found that radiotherapy did not impact overall survival (P = .384) or progression free survival (P = .420), but survival curves show better overall survival in the radiotherapy groups. Finally, observances of toxicities were rare.

“Radiotherapy did not impact survival or progression in our limited sample, but a longer overall survival may occur after the first-year post radiotherapy,” they concluded. “Radiotherapy should be tested in prospective data in the HIV + population with DLBCL.”  

—Julie Gould

Reference:

Casimiro LC, Mauro GP, Medici CTM, Waltman E. Survival and consolidative radiotherapy in patients living with HIV and treated for diffuse large B-cell lymphoma [published online October 1, 2020]. Rep Pract Oncol Radiother. doi: https://doi.org/10.1016/j.rpor.2020.09.004