Central nervous system involvement in AIDS‐related lymphomas
Abstract
Central nervous system (CNS) involvement is reportedly more common in acquired immunodeficiency syndrome (AIDS)‐related lymphomas (ARL). We describe factors and outcomes associated with CNS involvement at baseline (CNSB) and relapse (CNSR) in 886 patients with newly diagnosed ARL. Of 886 patients, 800 received either intrathecal (IT) therapy for CNSB or IT prophylaxis. CNSB was found in 13%. CNSB was not associated with reduced overall survival (OS). There was no difference in the prevalence of CNSB between the pre‐combination antiretroviral therapy (cART) and cART eras. 5·3% of patients experienced CNSR at a median of 4·2 months after diagnosis (12% if CNSB; 4% if not). Median OS after CNSR was 1·6 months. On multivariate analysis, only CNSB [hazard ratio (HR) 3·68, P = 0·005] and complete response to initial therapy (HR 0·14, P CNSR. When restricted to patients without CNSB, IT CNS prophylaxis with 3 vs. 1 agent did not significantly impact the risk of CNSR. Despite IT CNS prophylaxis, 5% of patients experienced CNSR. Our data confirms that CNSR in ARL occurs early and has a poor outcome. Complete response to initial therapy was associated with a reduced frequency of CNSR. Although CNSB conferred an increased risk for CNSR, it did not impact OS.
Document Details
- Document Type
- Pub Defense Publication
- Publication Date
- Apr 07, 2016
- Source ID
- 10.1111/bjh.13998
Entities
People
- Ariela Noy
- Christian Hoffmann
- Dan Wang
- Jitesh Joshi
- Joseph A. Sparano
- Josep‐maria Ribera
- Jose‐tomas Navarro
- Kieron Dunleavy
- Lionel Galicier
- Michele Spina
- Nicolas Mounier
- Richard F. Little
- Stefan K. Barta
- Wyndham H. Wilson
- Xiaonan Xue
Organizations
- Albert Einstein College of Medicine
- Fox Chase Cancer Center
- Hospital Universitari Germans Trias i Pujol
- National Cancer Institute
- National Center for Research Resources
- National Institutes of Health
- United States Army Materiel Command
- Weill Cornell Medicine