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Haematologica. 2018 May;103(5):857-864. doi: 10.3324/haematol.2017.180893. Epub 2018 Feb 8.

Incidence and risk factors for relapses in HIV-associated non-Hodgkin lymphoma as observed in the German HIV-related lymphoma cohort study.

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Department I of Internal Medicine, University Hospital Cologne, Germany
German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Germany.
Department I of Internal Medicine, University Hospital Cologne, Germany.
Department of Medicine III, Red Cross Hospital Munich, Germany.
Praxis am Ebertplatz, Cologne, Germany.
Department of Medicine II, University of Frankfurt, Germany.
Department of General Medicine, Gastroenterology and Infectious Diseases, Augustinerinnen Hospital, Cologne, Germany.
Department of Medicine IV, Kaiser Franz Josef Hospital, Vienna, Austria.
Department of Internal Medicine I, University of Bonn, Germany.
Department of Medicine IV, University of Munich, Munich, Germany.
Department of Infectious Diseases, Vivantes Auguste-Viktoria-Hospital, Berlin, Germany.
Department of Dermatology, University Hospital Essen, Germany.
University of Schleswig Holstein, Campus Kiel, Kiel, Germany.
Department of Gastroenterology, Hepatology and Infectious Diseases, Düsseldorf University Hospital, Germany.
Ifi-Institute for Interdisciplinary Medicine, Hamburg, Germany.
Department of Clinical Immunology and Rheumatology, Hannover Medical School, Germany.
German Center for Infection Research (DZIF), Hannover, Germany.
Department of Emergency Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Ärzteforum Seestraße, Berlin, Germany.
Medical Group Practice for Internal Medicine and Rheumatology, Freiburg, Germany.
Department of Internal Medicine III with Hematology, Medical Oncology, Hemostaseology, Infectious Diseases, Rheumatology, Oncologic Center, Laboratory of Immunological and Molecular Cancer Research, Paracelsus Medical University Salzburg, Austria.
IPM Study Center, Hamburg, Germany.


Outcome of HIV-infected patients with AIDS-related lymphomas has improved during recent years. However, data on incidence, risk factors, and outcome of relapses in AIDS-related lymphomas after achieving complete remission are still limited. This prospective observational multicenter study includes HIV-infected patients with biopsy- or cytology-proven malignant lymphomas since 2005. Data on HIV infection and lymphoma characteristics, treatment and outcome were recorded. For this analysis, AIDS-related lymphomas patients in complete remission were analyzed in terms of their relapse- free survival and potential risk factors for relapses. In total, 254 of 399 (63.7%) patients with AIDS-related lymphomas reached a complete remission with their first-line chemotherapy. After a median follow up of 4.6 years, 5-year overall survival of the 254 patients was 87.8% (Standard Error 3.1%). Twenty-nine patients relapsed (11.4%). Several factors were independently associated with a higher relapse rate, including an unclassifiable histology, a stage III or IV according to the Ann Arbor Staging System, no concomitant combined antiretroviral therapy during chemotherapy and R-CHOP-based compared to more intensive chemotherapy regimens in Burkitt lymphomas. In conclusion, complete remission and relapse rates observed in our study are similar to those reported in HIV-negative non-Hodgkin lymphomas. These data provide further evidence for the use of concomitant combined antiretroviral therapy during chemotherapy and a benefit from more intensive chemotherapy regimens in Burkitt lymphomas. Modifications to the chemotherapy regimen appear to have only a limited impact on relapse rate.

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