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Primary central nervous system lymphoma in patients with and without HIV infection: a multicenter study and comparison with U.S national data.
- Source :
-
Cancer causes & control : CCC [Cancer Causes Control] 2019 May; Vol. 30 (5), pp. 477-488. Date of Electronic Publication: 2019 Mar 19. - Publication Year :
- 2019
-
Abstract
- Purpose: Primary central nervous system lymphoma (PCNSL) in patients living with HIV (PLWH) is a distinct entity; however, the management is adopted from patients without HIV. The study aims to examine the differences in presentation, treatment, and outcomes of PCNSL patients with or without HIV.<br />Methods: We retrospectively compared the characteristics of 144 patients with PCNSL with and without HIV, and analyzed factors associated with overall and progression-free survival. Results were compared to the Central Brain Tumor Registry of the United States (CBTRUS) and the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) system.<br />Results: Among all patients with PCNSL, 19% had HIV. PLWH were younger (38 vs. 63 years; p < 0.01) and more likely to be African American (59% vs. 7%; p < 0.01) and male (74% vs. 49%; p = 0.02) than patients without HIV. PLWH were more likely to have multiple lesions (67% vs. 43%; p = 0.02), hemorrhage (59 vs. 37%; p = 0.03), and peripheral rim enhancement (57% vs. 7%; p < 0.01) on imaging; to receive palliative care (15% vs. 2%) or whole brain radiation (63% vs. 3%); and less likely to receive chemotherapy (22% vs. 95%) (p < 0.01). Twenty-four patients, none PLWH, underwent stem cell transplant. Not receiving transplant was an independent factor in mortality and disease progression. Our cohort of patients, compared to the national database, were younger (60 vs. 65 years), 58% were white vs. 75%, and had longer median overall survival 43 vs. 25 months.<br />Conclusion: Epidemiology, imaging, and treatment options for patients with PCNSL with and without HIV differ, but HIV was not an independent factor of mortality or disease progression. More efforts are needed to improve access to research and treatment options for PLWH with PCNSL.
- Subjects :
- Adult
Black or African American statistics & numerical data
Aged
Cohort Studies
Disease Progression
Female
Humans
Male
Middle Aged
Progression-Free Survival
Registries
Retrospective Studies
United States epidemiology
Brain Neoplasms epidemiology
Central Nervous System Neoplasms epidemiology
HIV Infections epidemiology
Lymphoma, Non-Hodgkin epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1573-7225
- Volume :
- 30
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Cancer causes & control : CCC
- Publication Type :
- Academic Journal
- Accession number :
- 30888569
- Full Text :
- https://doi.org/10.1007/s10552-019-01144-8