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Primary CNS lymphoma in HIV positive and negative patients: comparison of clinical characteristics, outcome and prognostic factors

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Abstract

Primary central nervous system lymphoma (PCNSL) accounts for approximately 4% of all primary brain tumors and has a poor prognosis in both immunocompetent as well as in immunocompromised patients. We conducted a retrospective analysis to examine the clinical characteristics and prognostic factors in HIV-negative and HIV-positive patients with PCNSL and to assess the effect of highly active antiretroviral therapy (HAART) therapy on the outcome of HIV-positive patients. Patients diagnosed with PCNSL between 1999 and 2008 at our institution were divided into two groups based on their HIV status. Their demographic and clinical characteristics were compared using the chi-square test. Kaplan–Meier survival curves were constructed employing the univariate log-rank test. Multivariate analyses of survival were performed by Cox proportional hazards models incorporating the prognostic factors identified in the univariate log rank test. Forty-one HIV-positive patients and 45 HIV-negative patients were identified. HIV-positive patients were younger, more likely to present with seizures and elevated serum LDH levels. There were significant differences in complete remission (CR) rates (P = 0.010) and overall survival (OS) (P = 0.034) in favor of the HIV-negative group. In the HIV-positive group, OS was better in patients with KPS > 70 and patients who received HAART, but remained inferior to that in the HIV-negative patients. HIV-positive patients had a worse prognosis compared to HIV-negative patients despite similar clinical characteristics. Better performance status (KPS > 70) and treatment with HAART conferred better OS in HIV-positive patients.

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Acknowledgment

ISL is supported by the United States Public Health Service, National Institutes of Health [grant numbers R01-CA109335, R01-CA122105], Fidelity Foundation and the Dwoskin Family Foundation.

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Authors and Affiliations

  1. Division of Hematology and Oncology, Department of Medicine, University of Miami, Sylvester Comprehensive Cancer Center, 1475 NW 12th Ave (D8-4), Miami, FL, 33136, USA

    Soley Bayraktar, Ulas D. Bayraktar, Juan C. Ramos, Alexandra Stefanovic & Izidore S. Lossos

  2. Department of Molecular and Cellular Pharmacology, Miller School of Medicine, University of Miami, Miami, FL, 33136, USA

    Izidore S. Lossos

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  1. Soley Bayraktar
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  2. Ulas D. Bayraktar
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  3. Juan C. Ramos
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  4. Alexandra Stefanovic
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  5. Izidore S. Lossos
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Correspondence to Izidore S. Lossos.

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This article is dedicated to Dr. William J. Harrington who devoted his life for treatment of lymphoma in HIV-positive patients.

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Bayraktar, S., Bayraktar, U.D., Ramos, J.C. et al. Primary CNS lymphoma in HIV positive and negative patients: comparison of clinical characteristics, outcome and prognostic factors. J Neurooncol 101, 257–265 (2011). https://doi.org/10.1007/s11060-010-0252-3

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  • DOI: https://doi.org/10.1007/s11060-010-0252-3

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