Combined Antiretroviral Therapy During Chemotherapy for HIV-Patients with Hodgkin and non-Hodgkin Lymphoma: A review of tolerability and survival outcomes

Ibrahim, Karim (2012). Combined Antiretroviral Therapy During Chemotherapy for HIV-Patients with Hodgkin and non-Hodgkin Lymphoma: A review of tolerability and survival outcomes Other, School of Pharmacy, The University of Queensland.

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Author Ibrahim, Karim
Thesis Title Combined Antiretroviral Therapy During Chemotherapy for HIV-Patients with Hodgkin and non-Hodgkin Lymphoma: A review of tolerability and survival outcomes
School, Centre or Institute School of Pharmacy
Institution The University of Queensland
Publication date 2012-11-01
Thesis type Other
Open Access Status Other
Supervisor Lisa Nissen
Sam Milliken
Total pages 176
Total colour pages 77
Total black and white pages 99
Language eng
Subjects 111503 Clinical Pharmacy and Pharmacy Practice
Formatted abstract
Aim
The aim of our study was to compare toxicities, response rates and survival outcomes in patients with HIV-associated lymphoma treated with chemotherapy according to whether patients received protease inhibitor (PI) or non-PI based combination antiretroviral therapy (cART).
Methods
A retrospective study, which included HIV-infected patients on cART receiving chemotherapy for non-Hodgkin and Hodgkin lymphoma between 2003 and 2010 at a single institution. We compared differences in adverse effects between patients on PI and non-PI based cART. Differences in response rates, overall survival (OS) and disease free survival (DFS) were investigated.
Results
A total of 53 patients were included, with 47% and 53% were on PI and non-PI based cART, respectively. Median baseline CD4 cell count value for all 53 patients were 273 cells/μL (range 14-970). Baseline HIV viral load (VL) was undetectable (<50 copies/mL) in 15 (28%) of patients. PI-based cART was significantly associated with more grade 3-4 neurotoxicity (OR= 11.42, 95% CI 1.7-76.49, p-value=0.012) and grade 3-4 infections (OR=14.08, 95% CI 2.13-93.07, p-value=0.006). Patients on non-PI based cART were more likely to complete their stage appropriate chemotherapy treatment compared to those on PI-based cART (p-value=0.023), but there were no differences in response rates, OS or DFS between the two groups.
Conclusion
This study demonstrated that PI-based cART was significantly associated with more treatment related toxicities compared to non-PI based cART in HIV-patients with lymphoma undergoing chemotherapy. If appropriate, non-PI based cART should be considered during chemotherapy to minimise toxicities.
Keyword Combined Antiretroviral Therapy
Hodgkin and non-Hodgkin Lymphoma
hiv patients

 
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Created: Tue, 21 May 2013, 14:31:15 EST by Vanessa Lee King on behalf of School of Pharmacy