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J Acquir Immune Defic Syndr. 2011 Apr;56(4):312-9. doi: 10.1097/QAI.0b013e31820c011a.

Predictors of survival after a diagnosis of non-Hodgkin lymphoma in a resource-limited setting: a retrospective study on the impact of HIV infection and its treatment.

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  • 1Department of Global Health, University of Washington, Seattle, WA 98104, USA. bategm@u.washington.edu

Abstract

OBJECTIVE:

We examined factors associated with survival among patients with newly diagnosed non-Hodgkin lymphoma (NHL) in Uganda.

METHODS:

Information was abstracted from medical records for all NHL patients >13 years of age at the Uganda Cancer Institute between January 2004 and August 2008. Cox proportional hazard models were used to identify predictors of NHL survival.

RESULTS:

One hundred sixty patients with NHL were identified; 51 (31.9%) were known to be HIV positive. Overall, 154 patients had records sufficient for further analysis. The median person-time observed was 104 days (interquartile range 26-222). Median survival after presentation among those whose mortality status was confirmed was 61 days (interquartile range 25-203). HIV-positive patients receiving antiretroviral therapy had survival rates approximating those of HIV-negative persons, but the adjusted hazard of death was significantly elevated among HIV-positive patients not receiving antiretroviral therapy [adjusted hazard ratio (HR) 8.99, P < 0.001] compared with HIV-negative patients. Both B-symptoms (HR 2.08, P = 0.05) and female gender (HR 1.72, P = 0.05) were associated with higher mortality.

CONCLUSIONS:

In Uganda, overall survival of NHL patients is poor, and predictors of survival differed from those described in resource-rich regions. HIV is a common comorbidity to NHL, and its lack of treatment was among the strongest predictors of mortality. Strategies are needed for optimal management of HIV-infected individuals with cancer in resource-limited settings.

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PMID:
21350364
[PubMed - indexed for MEDLINE]
PMCID:
PMC3065203
Free PMC Article
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