Patients with HIV-Associated Lymphoma Can Safely Continue Anti-Retroviral Therapy During Chemotherapy

PHILADELPHIA (December 1, 2017) – HIV patients who are treated with combination anti-retroviral therapy (cART) can safely undergo chemotherapy to treat associated lymphomas at the same time, researchers from the AIDS Malignancy Consortium, including Fox Chase Cancer Center have found. The findings are available early online in the journal Leukemia and Lymphoma.

There is no prospective clinical trial evaluating the role of concurrent cART with chemotherapy when treating HIV-associated lymphoma. Therefore, some physicians opt to suspend cART for the duration of chemotherapy to avoid drug interactions and possible increased side effects. However, researchers found that the combination of chemotherapy and cART was well tolerated, and that patients’ CD4 counts rebounded to baseline levels after chemotherapy at a faster rate when receiving cART concurrent with chemotherapy. They did not see an improvement in overall outcomes but noted that in addition to CD4 count recovery, patients’ HIV viral load stayed lower when cART was continued throughout cancer treatment.

“Within this one prospective clinical trial from the AIDS Malignancy Consortium, we found that HIV patients with lymphoma can safely continue anti-retroviral therapy while receiving chemotherapy,” said Carlyn Tan, MD, assistant professor of hematology/oncology at Fox Chase and lead author of the study. “Importantly, patients who have HIV-associated lymphoma should consult with a specialist with expertise in cART and chemotherapy interactions because he or she will be aware of drug interactions and can make the necessary adjustments.”

According to the National Cancer Institute, being HIV positive increases a person’s risk for several cancers. A person who has HIV has approximately twelve times higher risk for non-Hodgkin’s lymphoma compared to the average risk population.

“Combining chemotherapy with ART has been a contentious issue,” said Ariela Noy, MD, attending physician at Memorial Sloan Kettering and the study’s senior author. “As a randomized study is impossible, we investigated concurrent or delayed ART in a single prospective study and found no detriment to the patients and faster immune reconstitution when ART was given with chemotherapy. This finding and supportive evidence from infectious disease trials support the use of ART with chemotherapy in patients living with HIV.”  

Fox Chase Cancer Center (Fox Chase), which includes the Institute for Cancer Research and the American Oncologic Hospital and is a part of Temple Health, is one of the leading comprehensive cancer centers in the United States. Founded in 1904 in Philadelphia as one of the nation’s first cancer hospitals, Fox Chase was also among the first institutions to be designated a National Cancer Institute Comprehensive Cancer Center in 1974. Fox Chase is also one of just 10 members of the Alliance of Dedicated Cancer Centers. Fox Chase researchers have won the highest awards in their fields, including two Nobel Prizes. Fox Chase physicians are also routinely recognized in national rankings, and the Center’s nursing program has received the Magnet recognition for excellence six consecutive times. Today, Fox Chase conducts a broad array of nationally competitive basic, translational, and clinical research, with special programs in cancer prevention, detection, survivorship, and community outreach. It is the policy of Fox Chase Cancer Center that there shall be no exclusion from, or participation in, and no one denied the benefits of, the delivery of quality medical care on the basis of race, ethnicity, religion, sexual orientation, gender, gender identity/expression, disability, age, ancestry, color, national origin, physical ability, level of education, or source of payment.

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