2015 March 18

A new study examines the effect of HIV infection on patients being treated for a type of Non-Hodgkin’s Lymphoma called aggressive B-cell lymphoma with immuno-chemotherapy

A study carried out at the ICO-Germans Trias Campus shows that HIV-infected patients have the same chance of being cured of aggressive B-cell lymphoma than those who are HIV-negative

HIV-positive people are at a great risk of contracting other infections and illnesses and many of them develop a type of Non-Hodgkin’s Lymphoma, called aggressive B-cell lymphoma, a cancer of the blood and lymph nodes. Treatment for nearly all HIV-patients has improved as they are now given a cocktail of drugs that work together to control the disease; this cocktail is known as combined antiviral therapy or c-ART. HIV positive patients with Non-Hodgkins Lymphoma are given an additional combination of immuno-chemotherapy drugs for the cancer. Until now there has been very little data on the differences in cure and survival between people with Non-Hodgkins Lymphoma who have HIV and those who don't, when taking the sameimmune-chemotherapy. Moreover, it is still on debate if HIV-infected patients should be treated for lymphoma in the same way as HIV-uninfected.

In a study published in the well-known journal in the field AIDS, researchers of the Josep Carreras Research Institute (IJC) studied two groups of patients receiving the same combined immuno-chemotherapy for aggressive B-cell Lymphoma, one group with HIV and another without.   The lymphoma treatment is also a combination of 5 drugs and its name, R-CHOP, comes from the first letter of each of the drugs (Rituximab, Cyclophosphamide, Doxorubicin Hydrochloride (Hydroxydaunorubicin), Vincristine Sulphate (Oncovin) and Prednisone).

The work involved patients treated in several hospitals in Spain, but it was led by Dr Maria Joao Baptista of the IJC, working in the Lymphoid Neoplasms Research group led by Dr Tomas Navarro. Dr Baptista explains that it is important to carry out such studies in order to know exactly how effective the treatment for the lymphoma is in HIV-infected patients and how to keep them healthy longer. Simply put, when people are taking such large combinations of drugs it is essential to know that the benefits outweigh the side effects.

The study shows that although lymphoma is usually more aggressive in HIV-infected people they live similar time after being cured for lymphoma and without symptoms, than people without HIV, showing that it is worth giving HIV-infected people the immune-chemotherapy for lymphoma on top of their HIV medication. In other words, HIV-infected patients have the same chance of being cured of aggressive B-cell lymphoma than those who are HIV-negative.

However, the team conclude that their overall survival time is shorter, despite living a similar time lymphoma-free than their non-HIV counterparts. This is because, despite being cured for lymphoma, HIV-infected patients can still die from HIV-related complications or cancers other than lymphoma. As for all patients, early diagnosis and treatment for lymphoma is essential for HIV-infected patients and prevention of complications related to the virus is important to improve their chances of combating cancer.

See the full paper