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HAART improves prognosis of AIDS-related lymphoma
  By Megan Rauscher
NEW YORK (Reuters Health) - Results of a study show that highly active antiretroviral therapy (HAART) significantly improves the clinical outcome and overall survival of patients with AIDS-related lymphoma (ARL), independently of the chemotherapy regimen used.
"These findings suggest that improvement in the control of HIV disease with HAART leading to immune restoration is essential to improve the outcome of AIDS-related non-Hodgkin's lymphoma," Dr. Anne-Sophie Lascaux from Hopital Henri Mondor in Creteil, France and colleagues write in the March issue of AIDS Research and Human Retroviruses.
They took a look back at the influence of HAART on the survival of 73 patients with proven ARL who were observed over an 8-year period (1992-2000).
"Compared to other studies addressing the same question, the originality of our study is that patients were uniformly assigned to receive the same chemotherapy regimen according to CD4 cell counts at ARL diagnosis during the extended period of the study," Dr. Lascaux explained in comments to Reuters Health.
"This allowed us to determine the impact of HAART on the clinical outcome of patients independently of the chemotherapy regimen used for the treatment of ARLs," she added.
According to the team, the estimated event-free survival was significantly better in the 35 patients treated with HAART than in the 38 who never received HAART (30 months vs 6 months, p = 0.03). Likewise, the median overall survival was significantly higher, 22.4 months vs 6.1 months, respectively (p = 0.004).
In a multivariate Cox model, HAART was an independent prognostic factor for complete remission, overall survival, and event-free survival.
"The combination of HAART and chemotherapy did not preclude the tolerance of HAART or the schedule of chemotherapeutic regimen in these patients and should be considered as the standard of care of these patients," Dr. Lascaux said.
These findings support another study, which showed that ARL responds best to combination chemotherapy and HAART. (See Reuters Health report Aug. 29, 2001).
AIDS Res Hum Retroviruses 2005;21:214-220.
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