Publication Date:
2014-12-06
Description:
Introduction. There are scarce prospective data for lymphoma patients in sub-Saharan Africa since antiretroviral therapy (ART) scale-up began. We report early data from the Kamuzu Central Hospital (KCH) Lymphoma Study in Lilongwe,Malawi. KCH is the cancer referral center for Malawi’s northern and central regions. Methods. The KCH Lymphoma Study is a prospective observational cohort study initiated in June 2013. All diagnoses are pathologically confirmed using core biopsies or cell blocks from fine needle aspirates, supported by immunohistochemistry and weekly telepathology consultation between pathologists in Malawi and the US. Adult patients with confirmed lymphoma receive a comprehensive baseline evaluation including standardized staging. Patients undergo longitudinal follow-up with active tracing and transportation reimbursement to promote adherence to care. Response is assessed using standardized criteria incorporating physical exam, chest x-ray, and abdominal ultrasound. For these analyses, we focused on adults ≥18 years enrolled from June 1, 2013 until May 31, 2014. Chemotherapy protocols are standardized, and HIV+ patients receive ART concurrently with chemotherapy. Results. Seventeen of 38 (45%) of patients with lymphoma were HIV+. Baseline characteristics for HIV+ and HIV- patients were similar although HIV- patients presented with bulkier disease (median 10 vs 6 cm, p=0.027, Table 1). Among HIV+ patients, 82% were on ART for a median 22.5 months before lymphoma diagnosis (range 0.2-98.8). Median CD4 was 178 cells/µL and 53% had suppressed HIV RNA
Print ISSN:
0006-4971
Electronic ISSN:
1528-0020
Topics:
Biology
,
Medicine
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