Experience in the treatment of Hodgkin’s lymphoma associated with HIV

Abstract

Background. Among malignant neoplasms in HIV-infected patients lymphomas occupy a special place due to the high incidence, course characteristics, and difficulties that arise during diagnosis and during antitumor drug therapy. Hodgkin’s lymphoma (HL) is not an AIDS indicating disease, but the risk of its development in people infected with HIV is 5–25 times higher than the incidence of HL in the general population. Prior to the use of antiretroviral therapy, the results of standard chemotherapy in HIV-infected patients with HL were significantly worse than in HIV-negative patients. One of the main requirements for drug treatment of this group of patients is the simultaneous use of antiretroviral therapy and chemotherapy. The aim was to study the clinical characteristics and results of treatment of HL in the presence of HIV infection. Materials and methods. The analysis included 24 HL patients with HIV infection who received treatment in the Department of Radiation and Drug Therapy of Hemoblastoses of the MRRC in the period from 2018 to 2022. Treatment program selection was in accordance with the HL treatment protocol developed at our Center. Patients received 4–6 cycles of ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) or 6 cycles of BEACORP (bleomycin, vepesid, doxorubicin, cyclophosphamide, vincristine, dacarbazine, prednisolone) chemotherapy according to the stage of the disease and the risk factors generally accepted for patients with HL. The response to therapy was assessed according to the Lugano-2014 criteria. Descriptive statistics methods were used. Overall survival and progression-free survival were analyzed using the Kaplan-Meier method. Results. HL occurring against the background of HIV is most often represented by a widespread nodal and extranodal lesion, accompanied by symptoms of intoxication (B-symptoms). The use of standard CT regimens as induction therapy for HL in the presence of HIV makes it possible to obtain satisfactory immediate and long-term results of treatment. In our study complete and partial responses were achieved in 94.1 %. With a median follow-up of 12 months survival without progression and overall survival were 75 % and 100 % respectively.