Linfoma relacionado a infección por virus de la inmunodefciencia humana en un hospital público de Santiago, Chile.

Resumen

HIV-RELATED LYMPHOMA IN A PUBLIC HOSPITAL IN CHILE. ANALYSIS OF 55 CASES

Background: Cancer is the third cause of death in patients infected with human immunodeficiency virus (HIV) and lymphoma is the most common type. Aim: To describe the clinical characteristics, histology, risk factors and prognosis of these patients, in a Chilean public hospital in Chile. Material and methods: Records of  55 patients (45 males) aged between 23 and 67 years with lymphoma and  HIV positive serology, diagnosed between 1992-2008, were reviewed. Results: Six patients (11%) had Hodgkin lymphoma (HL) and the rest, non-Hodgkin lymphoma (NHL). B-cell phenotype constituted 83.7% of NHL cases. The most common subtype was diffuse large B cell lymphoma in 24 cases (49%), followed by Burkitt lymphoma in 12 cases (24.5%), T and T/NK cell lymphoma in 8 cases (16.3%) and plasmablastic lymphoma in 5 cases (10.2%). Thirty five patients (64%) underwent curative intended chemotherapy (CT) concomitantly with highly active antiretroviral therapy (HAART). Three year  survival of the whole cohort was 27%. By multivariate analysis, the most important prognostic factors for long term survival, were complete response  to CT, (p<0.01) and a low international prognostic index (IPI) score for NHL, (p=0.01).  HAART, histologic subtype and CD₄ lymphocyte count at diagnosis, did not influence survival. Conclusions: The most important prognostic factors for HIV patients with lymphoma, were achieving CR with CT and low IPI score. Prognosis remains poor, even with HAART therapy.