Hodgkin lymphoma among patients infected with HIV in post-HAART era.

Background: Hodgkin lymphoma is considered a common type of non-AIDS defining tumor among patients infected with HIV, commonly presenting as a widespread disease and with different pathologic features compared with Hodgkin lymphoma in the general population. Despite that, the best treatment option is undefined.

Patients And Methods: The authors present a retrospective study of 31 patients with Hodgkin lymphoma-HIV attended at 3 Brazilian centers, 2 of them considered reference centers for HIV treatment. Chemotherapy schemes used were ABVD (doxorubicin/bleomycin/vinblastine/dacarbazine) or hybrid MOPP-ABV (mechlorethamine/vincristine/procarbazine/prednisone-doxorubicin/bleomycin/vinblastine), with prophylactic granulocyte colony-stimulating factor.

Results: Treatment response could be evaluated in 22 patients (70.9%) who completed initial treatment: 20 (91%) reached complete remission, 1 had partial remission, and 1 did not exhibit a response. The overall response rate was 95.5% (95% confidence interval, 91.2%-99.8%). After a median follow-up of 3 years, the overall survival (OS) rate among all patients was 80.3%; median OS was not reached. On univariate analysis, only CD4 cell count at diagnosis was significantly related to survival.

Conclusion: This retrospective study shows that for patients with Hodgkin lymphoma development in the HIV setting in these 3 Brazilian centers, there was high complete remission and satisfactory OS rates, comparable with results found for Hodgkin lymphoma in patients without HIV.