RESUMO
BACKGROUND: Non-Hodgkin lymphoma (NHL) is the most common cancer in people with HIV. Although 95% of HIV patients are in developing countries like Peru, the majority of these studies have been conducted in developed countries. In this study we aim to evaluate prognostic factors associated with outcomes in HIV positive patients undergoing systemic therapy for treatment of NHL. METHODS: This retrospective study includes patients with NHL seen in the Instituto Nacional de Enfermedades Neoplasicas (INEN) between 2004 to 2014. Patients were divided into two groups: antiretroviral therapy (ART) -naïve (n = 34) and those previously treated, ART-exposed (n = 13), at the time of diagnosis. All patients received chemotherapy and ART. The medical records were reviewed. Data were analyzed using t-test and chi-square test. Survival curves were estimated by the Kaplan-Meier method and comparison was done by log-rank test. Multivariate analysis for overall survival (OS) was performed with the Cox proportional hazard regression model. RESULTS: All ART-exposed patients were from the capital city (p = 0.039); they had significantly lower hemoglobin levels compared to ART-naïve patients (p = 0.026). The median OS was 47.7 months with a 5-yr OS of 36.1%. The median OS for ART naïve patients was significantly higher than that for ART-exposed patients (57.05 and 21.09 months, respectively; p = 0.018). Advanced stage and low serum albumin were associated with lower OS in both groups. Age > 60 was associated with worse outcomes in the ART-naïve cohort. CONCLUSIONS: Advanced stage, low serum albumin and previous ART treatment were the primary prognostic factors associated with poorer outcomes in patients with NHL and HIV infection. In ART-naïve patients, age > 60 was associated with worse outcomes but in this cohort, older patients still had better overall outcomes than ART-exposed patients.
Assuntos
Pesquisa Biomédica/métodos , Oncologia/métodos , Neoplasias/diagnóstico , Neoplasias/terapia , Relatórios Anuais como Assunto , Pesquisa Biomédica/economia , Pesquisa Biomédica/tendências , Detecção Precoce de Câncer , Testes Genéticos , Humanos , Oncologia/organização & administração , Oncologia/tendências , Neoplasias/genética , Medicina de Precisão/métodos , Medicina de Precisão/tendências , Apoio à Pesquisa como Assunto/estatística & dados numéricos , Sociedades Médicas , Estados UnidosRESUMO
Dr Milton Douglas Quigless, a graduate of Meharry Medical College, arrived in Tarboro, North Carolina, in 1936 to practice medicine. For 10 years, he tried to obtain hospital privileges at the Edgecombe General Hospital, but segregation laws prevented him from performing surgery and admitting ill patients to this local facility. After years of frustration, Dr Quigless decided to establish his own hospital so that he could adequately care for his patients. In 1946, the doors of the Quigless Hospital-Clinic opened--the first hospital for blacks in Tarboro. As a noted family physician and distinguished community leader, Dr Quigless had an enormous impact on the lives of multiple generations of North Carolinians.
