Outcomes of human immunodeficiency virus‐associated Burkitt lymphoma and diffuse large B‐cell lymphoma treated in Australia: A report from the Australasian Lymphoma Alliance

Abstract

SummaryAntiretroviral therapy (ART) has improved outcomes for human immunodeficiency virus‐associated non‐Hodgkin lymphoma (HIV‐NHL). This is an analysis of 44 patients with HIV with Burkitt lymphoma (HIV‐BL) and diffuse large B‐cell lymphoma (HIV‐DLBCL) treated in Australia over a 10‐year period (2009–2019) during the ART and rituximab era. At HIV‐NHL diagnosis, the majority of presenting patients had adequate CD4 counts and undetectable HIV viral load <50 copies/mL. More than 80% of patients received chemotherapy with curative intent, rituximab, and concurrent ART with chemotherapy (immunotherapy). R‐CODOX‐M/IVAC or R‐Hyper‐CVAD (55%) were most commonly used in HIV‐BL. CHOP (58%) was the most commonly used chemotherapy backbone for HIV‐DLBCL, although 45% of patients received more intense chemotherapy regimens. Overall, 93% of patients who received curative therapy completed their intended course. The 2‐year progression‐free survival (PFS) and overall survival (OS) for the HIV‐BL cohort was 67% and 67% respectively. The 2‐year PFS and OS for the HIV‐DLBCL cohort was 77% and 81% respectively. Treatment related mortality was 5%. In all, 83% of patients achieved a CD4 count of >0.2 ×109/L 6 months after the end of treatment. Current Australian practice favours the treatment of HIV‐BL and HIV‐DLBCL similarly to the HIV‐negative population with the use of concurrent ART, achieving outcomes comparable to the HIV‐negative population.