HIV Status Does Not Impact First-Line Treatment Outcomes in Patients with Hodgkin Lymphoma

A study presented at the 2020 Society of Hematologic Oncology Annual Meeting observed that among patients with advanced classical Hodgkin lymphoma (HL), both those with and without HIV achieved similar treatment outcomes, thus “prognosis … is similar,” the authors noted.

The incidence of classical HL is five to 20 times higher among individuals with HIV, and the use of combined antiretroviral therapy and elevated CD4 counts may contribute to this risk, so researchers conducted this study to determine whether HIV status impacts lymphoma treatment outcomes.

This observational descriptive study took place between August 2004 and December 2018 and included 21 patients (all male) with HIV (mean age, 42.9 years) and 58 patients without HIV (mean age, 45.1 years), all with classical HL. All patients received first-line ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) chemotherapy, and those with HIV continued antiretroviral therapy.

Patients with HIV had significantly lower leucocyte counts (4.6×103 cells/mL vs. 6.7×103 cells/mL; P=0.02). Median time from classical HL diagnosis was 40 months in those with HIV. Median follow-up in the HIV cohort was shorter than the non-HIV group (10 months vs. 45 months; P=0.01).

Complete response was 61.1% in patients with HIV and 66.1% of those without (P=0.77). Relapse-free survival was 24 months for those with HIV versus 51 months for those without (P=0.03). Median overall survival was not reached at last follow-up. A total of 22 deaths (27.8%) occurred: six (28.6%) in the HIV cohort and 16 (27.6%) in the non-HIV group (P=1.00).

Age 45 years or older (P=0.02) and stage IV classical HL (P=0.03) were adversely associated with survival, and International Prognostic Score greater than 3 significantly predicted mortality (P=0.01).

“The prognosis of advanced clinical stage HIV-positive classical HL is similar to non-HIV classical HL patients treated with first-live ABVD chemotherapy,” the researchers concluded.