Annals of Oncology Advance Access originally published online on March 24, 2006
Annals of Oncology 2006 17(6):914-919; doi:10.1093/annonc/mdl063
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© 2006 European Society for Medical Oncology
Highly active antiretroviral therapy (HAART) improves survival in HIV-associated Hodgkin's disease: results of a multicenter study
1 Department of Hematology/Oncology, Hospital Harlaching, Munich; 2 Department of Infectious Diseases, Auguste Victoria Hospital, Berlin; 3 Department of Hematology/Oncology, University Hospital Frankfurt, Frankfurt; 4 Department of Internal Medicine, University Hospital Innenstadt, Munich; 5 Department of Infectious Diseases, Charité University Medicine, Berlin; 6 KIS-Curatorium for Immunodeficiency, Munich; 7 Department of Internal Medicine, University Hospital Münster; 8 Department of Internal Medicine I, University Hospital Bonn; 9 Department of Hematology/Oncology, Charité University Medicine, Berlin; 10 Clinic for Gastroenterology, Hepatology, and Infectious Diseases, University Clinic Düsseldorf; 11 Practice for Hematology, Oncology and Infectious Diseases, Bremen, Germany
* Correspondence to: Dr M. Hentrich, Munich Harlaching Hospital, Academic Teaching Hospital of the University of Munich, Department of Hemtaology-Oncology, Sanatoriumsplatz 2, 81545 Munich, Germany. Tel: +49-89-62103363; Fax: +49-89-62103320; E-mail: tumorzentrum.hentrich{at}khmh.de
Background: The purpose of the study was to evaluate the outcome of Hodgkin's disease (HD) in patients infected with the human immunodeficiency virus (HIV) with respect to the use of highly active antiretroviral therapy (HAART).
Materials and methods: This cohort study included patients with HIV-HD diagnosed from June 1984 to February 2004. Patients treated in the pre-HAART era (1984–1996) were compared with those belonging to the HAART era (1997–2004).
Results: Of 66 patients with HIV-HD, 47 (71%) presented with stage III/IV disease and 38 patients (58%) with an AIDS-defining illness. Fifty-nine of 66 patients (89.4%) underwent curative intended chemotherapy. Patients receiving HAART (n = 34) had a significantly better 2-year overall survival (OS) than those not receiving HAART (74% versus 30%, P <0.001). The 2-year OS of HAART-responders was 88% compared with 19% in patients without HAART-response (P = 0.0002). By multivariate analysis patients without HAART had a 5.6-fold higher risk for 3-year mortality [HR 5.6, 95% confidence interval (CI) 2.20–14.26]. Three-year mortality was significantly higher in patients without complete remission (HR 4.40, CI 1.77–10.99), with stage III/IV HD (HR 4.64, CI 1.31–16.49) and with CD4 cells <200/µl (HR 2.69, CI 0.99–7.33).
Conclusions: Use of HAART significantly improved the overall survival in patients with HIV-HD.
Key words: HIV infection, Hodgkin's disease, HIV-associated Hodgkin's disease, HIV-associated cancer, AIDS
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