Real-world treatment outcomes for Hodgkin lymphoma in South Africa: a prospective observational study.
Bone marrow involvement
HIV
Hodgkin lymphoma
Overall survival
Tuberculosis
Journal
Infectious agents and cancer
ISSN: 1750-9378
Titre abrégé: Infect Agent Cancer
Pays: England
ID NLM: 101276559
Informations de publication
Date de publication:
27 Sep 2024
27 Sep 2024
Historique:
received:
29
08
2024
accepted:
18
09
2024
medline:
28
9
2024
pubmed:
28
9
2024
entrez:
28
9
2024
Statut:
epublish
Résumé
Prospective data from sub-Saharan Africa suggests that treatment outcomes for people living with HIV (PWH) with Hodgkin lymphoma (HL) are similar to those without HIV. However, real-world data from high-resource settings and retrospective studies from sub-Saharan Africa, suggest inferior outcomes. We set out to evaluate the real-world treatment outcomes for HL in South Africa to better understand the disparate outcomes. We established a prospective, observational cohort of newly diagnosed, adult (≥ 18 years) HL cases recruited from Chris Hani Baragwanath Academic and Netcare Olivedale Hospitals in Johannesburg, South Africa between March 2021 and March 2023. Participants were followed for up to 18 months after enrollment with data censored on December 23rd, 2023. The primary endpoint was 1-year overall survival. We enrolled 47 participants with HL including 31 PWH and 16 HIV-negative. Advanced stage disease and B symptoms were common at time of diagnosis irrespective of HIV status. Bone marrow biopsy, performed during the work-up and evaluation of cytopenias, provided the initial diagnosis of HL in 16/31 (52%) PWH. HIV status and bone marrow involvement were associated with early mortality (within 3 months of diagnosis) and a poorer 1-year overall survival from diagnosis (HIV: 55% vs. 88%; p = 0.03; bone marrow involvement: 50% vs. 80%; p = 0.02). Among evaluable participants, those that received at least 6 cycles of chemotherapy and underwent response assessment, there was no difference between those with and without HIV. Traditional laboratory markers of poor prognosis including anemia, lymphopenia and hypoalbuminemia were more common among PWH and those with bone marrow involvement and suggest high risk disease. A better understanding of the drivers of these aggressive presentations is warranted to ensure more PWH are able to tolerate chemotherapy.
Sections du résumé
BACKGROUND
BACKGROUND
Prospective data from sub-Saharan Africa suggests that treatment outcomes for people living with HIV (PWH) with Hodgkin lymphoma (HL) are similar to those without HIV. However, real-world data from high-resource settings and retrospective studies from sub-Saharan Africa, suggest inferior outcomes. We set out to evaluate the real-world treatment outcomes for HL in South Africa to better understand the disparate outcomes.
METHODS
METHODS
We established a prospective, observational cohort of newly diagnosed, adult (≥ 18 years) HL cases recruited from Chris Hani Baragwanath Academic and Netcare Olivedale Hospitals in Johannesburg, South Africa between March 2021 and March 2023. Participants were followed for up to 18 months after enrollment with data censored on December 23rd, 2023. The primary endpoint was 1-year overall survival.
RESULTS
RESULTS
We enrolled 47 participants with HL including 31 PWH and 16 HIV-negative. Advanced stage disease and B symptoms were common at time of diagnosis irrespective of HIV status. Bone marrow biopsy, performed during the work-up and evaluation of cytopenias, provided the initial diagnosis of HL in 16/31 (52%) PWH. HIV status and bone marrow involvement were associated with early mortality (within 3 months of diagnosis) and a poorer 1-year overall survival from diagnosis (HIV: 55% vs. 88%; p = 0.03; bone marrow involvement: 50% vs. 80%; p = 0.02). Among evaluable participants, those that received at least 6 cycles of chemotherapy and underwent response assessment, there was no difference between those with and without HIV.
CONCLUSION
CONCLUSIONS
Traditional laboratory markers of poor prognosis including anemia, lymphopenia and hypoalbuminemia were more common among PWH and those with bone marrow involvement and suggest high risk disease. A better understanding of the drivers of these aggressive presentations is warranted to ensure more PWH are able to tolerate chemotherapy.
Identifiants
pubmed: 39334203
doi: 10.1186/s13027-024-00612-4
pii: 10.1186/s13027-024-00612-4
doi:
Types de publication
Journal Article
Langues
eng
Pagination
46Subventions
Organisme : FIC NIH HHS
ID : R25TW009340
Pays : United States
Organisme : NCI NIH HHS
ID : 5T32 CA09071; R01CA250069; R21CA232891; P30CA006973, P30AI094189
Pays : United States
Organisme : NCI NIH HHS
ID : 5T32 CA09071; R01CA250069; R21CA232891; P30CA006973, P30AI094189
Pays : United States
Organisme : NCI NIH HHS
ID : 5T32 CA09071; R01CA250069; R21CA232891; P30CA006973, P30AI094189
Pays : United States
Organisme : NCI NIH HHS
ID : 5T32 CA09071; R01CA250069; R21CA232891; P30CA006973, P30AI094189
Pays : United States
Organisme : NCI NIH HHS
ID : 5T32 CA09071; R01CA250069; R21CA232891; P30CA006973, P30AI094189
Pays : United States
Organisme : NCI NIH HHS
ID : 5T32 CA09071; R01CA250069; R21CA232891; P30CA006973, P30AI094189
Pays : United States
Organisme : NCI NIH HHS
ID : 5T32 CA09071; R01CA250069; R21CA232891; P30CA006973, P30AI094189
Pays : United States
Organisme : NCI NIH HHS
ID : 5T32 CA09071; R01CA250069; R21CA232891; P30CA006973, P30AI094189
Pays : United States
Organisme : NCI NIH HHS
ID : 5T32 CA09071; R01CA250069; R21CA232891; P30CA006973, P30AI094189
Pays : United States
Organisme : NIH HHS
ID : UM1CA121947
Pays : United States
Organisme : NIH HHS
ID : UM1CA121947
Pays : United States
Informations de copyright
© 2024. The Author(s).
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