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Regimen (Study/Year) [Reference] | Nos. Pts. | ORR (CR/PR) | Survival | Comment(s) |
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(A) Sub-Saharan Africa Data—Prospective trial (1) and key retrospective studies |
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Dose-modified oral chemo. (CWRU 2498/2009) [29] | 49 | 78% (CR 58%/PR 20%) | MST 12.3 mos. (33% 1-yr) | Only published prospective treatment trial of AR-NHL in sub-Saharan Africa; conducted comparable HIV therapeutic era as ACTG 142 trial [45]; 6% treatment mortality rate. |
Uganda Cancer Institute (NHL study/2011) [35] | 154 (32% HIV+) | No response data provided or types of chemotherapy. | MST 61 days (13% 1-yr) | Largest retrospective study on NHL including HIV(−) and HIV(+) cases ever reported with treatment and outcome data. Only 60% had acceptable clinical staging. |
Stellenbosch University (NHL study/2010) [19] | 512 (4 HIV+) | Overall CR range 46–75% for all subtypes; chemotherapy regimens not reported. | MST 10 mos. (50% 1-yr) | Comprehensive retrospective study of spectrum lymphoproliferative disorders at a major private referral centre in Cape Town. Only 4 cases (<1%) were HIV(+). MST is for the 4 AR-NHL cases. |
Uganda Cancer Institute (Pediatric BL study/2009) [34] | 228 (31% HIV+) | 36% CR HIV(+) 41% CR HIV(−) | MST 11.8 mos. HIV(+) Not reached HIV(−) | Comprehensive and largest retrospective study of pediatric BL in sub-Saharan Africa. No details on types of chemotherapy administered. |
University of Nairobi (BL study/2001) [36] | 796 with 29 adult BL (66% HIV+) | No response data reported or types of chemotherapy. | MST 15 wks. | Among earliest period prevalence and retrospective study that identified 3-fold increase in adult BL cases in the AIDS era. MST is for HIV(+) BL. |
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(B) United States Data—Select clinical trials |
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Concurrent R-EPOCH versus sequential R-EPOCH (AMC 034/2010 ) [53] | 48 concurrent 53 sequential | 73% CR concurrent 55% CR sequential | 2-yr OS 70% concurrent versus 67% sequential | Randomized phase II trial of concurrent versus sequential rituximab with EPOCH chemotherapy; the primary efficacy endpoint of CR achieved only for the concurrent arm. |
R-CHOP versus CHOP (AMC 010/2005) [49] | 150 | 58% CR R-CHOP 47% CR CHOP | 139 wks. OS R-CHOP 110 wks. OS CHOP | Randomized trial among first to use rituximab; raised concern with higher infectious deaths on R-CHOP arm; not substantiated in future trials with rituximab. |
Infusional CDE (ECOG E1494/2004) [48] | 98 | 45% CR | 2-yr OS 43% | Among largest studies of a highly active infusional regimen conducted during emergence of cART era. |
Infusional EPOCH (NCI/2003) [47] | 39 | 74% CR | 63% OS at 53 mos. | Dose-adjusted (on basis of CD4+ lymphocyte count) chemotherapy regimen with interruption of cART amongst highest CR and survival reported at time. |
LD and SD CHOP (AMC 005/2001) [46] | 40 LD 23 SD | 30% CR LD 48% CR SD | Not reported | Not randomized; 2 consecutive treatment arms established feasibility of concurrent chemotherapy with cART. Median duration of response 9 mos. LD; not reached for SD CHOP. |
LD versus SD m-BACOD (ACTG 142/1997) [45] | 98 LD 94 SD | 41% CR LD 52% CR SD | 35 wks. LD 31 wks. SD | Largest randomized clinical trial in AR-NHL ever conducted; established equivalence of LD versus SD in pre-cART era. |
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