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HAART
Improves Prognosis of AIDS-related Lymphoma
By Megan Rauscher
Results
of a study show that HAART
significantly improves the clinical outcome and overall survival
of patients with AIDS-related
lymphoma (ARL), independently of the chemotherapy regimen
used.
"These
findings suggest that improvement in the control of HIV disease
with HAART leading to immune restoration is essential to improve
the outcome of AIDS-related non-Hodgkin's lymphoma," Dr. Anne-Sophie
Lascaux from Hopital Henri Mondor in Creteil, France and colleagues
write in the March issue of AIDS Research and Human Retroviruses.
They
took a look back at the influence of HAART on the survival
of 73 patients with proven ARL who were observed over an
8-year period (1992-2000).
"Compared
to other studies addressing the same question, the originality of
our study is that patients were uniformly assigned to receive the
same chemotherapy regimen according to CD4 cell counts at ARL diagnosis
during the extended period of the study," Dr. Lascaux explained
in comments to Reuters Health.
"This
allowed us to determine the impact of HAART on the clinical outcome
of patients independently of the chemotherapy regimen used for the
treatment of ARLs," she added.
According
to the team, the estimated event-free survival was significantly
better in the 35 patients treated with HAART than in the 38 who
never received HAART (30 months vs 6 months, p = 0.03). Likewise,
the median overall survival was significantly higher, 22.4 months
vs 6.1 months, respectively (p = 0.004).
In
a multivariate Cox model, HAART was an independent prognostic factor
for complete remission, overall survival, and event-free survival.
"The
combination of HAART and chemotherapy did not preclude the tolerance
of HAART or the schedule of chemotherapeutic regimen in these patients
and should be considered as the standard of care of these patients,"
Dr. Lascaux said.
These
findings support another study, which showed that ARL responds best
to combination chemotherapy and HAART. (See Reuters Health report
Aug. 29, 2001).
AIDS
Res Hum Retroviruses 2005;21:214-220.
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