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Twenty-eight patients (7.8%) were people living with HIV. There were three-hundred fifty-nine (359) patients diagnosed with DLBCL and received radiation as consolidative treatment in our cohort. With this data, we try to improve how we treat DLBCL patients that are also people living with HIV. That has been shown in laboratory data as well as in retrospective clinical data for other cancer sites, but never in DLBCL. Both HIV infection and highly active antiretroviral therapy (HAART) can increase sensibility to radiotherapy. HIV has an important role in the toxicities in oncological treatments. Therefore, its use and indications, as its toxicities, are unknown.

In this cohort, nevertheless, radiotherapy was not part of the treatment. An important French prospective cohort has shown that survival among patients living with HIV and that are diagnosed with DLBCL are like HIV negative patients. It is a consensus that not every patient should receive RT and that better knowledge of the disease and the effects of radiation is the way that must be taken to improve patients’ outcomes.Īn important, yet understudied, part of DLBCL patients are infected with the human immunodeficiency virus (HIV). Since it is a consolidative therapy, it is important to address the correct indication and expected toxicities of RT in DLBCL patients. Nowadays, RT is an accepted option for consolidation in DLBCL. The International Lymphoma Radiation Oncology Group (ILROG) has proposed guidelines to its use. Advanced disease is yet another discussion.

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The upcoming results of the UNFOLDER trial will cast more light in the matter and publication is awaited since the no-RT arms were prematurely closed.

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Compared the no-inferiority between RT and no consolidative therapy in initial very low-risk DLBCL and reveal positive findings, even though that trial can be criticized by the low threshold given to the no-RT arm for the 5-year event free survival (EFS) and for accepting a difference of EFS between the two groups larger than the difference usually seen between low-IPI no bulky disease and high-risk disease. After the MabThera trial, radiation as a consolidative treatment was not a consensus. The role of radiotherapy (RT) in the treatment of non-Hodgkin diffuse large B-cell lymphomas (DLBCL) has been tested over the years. For HIV positive patients there was an increase in fatigue and hematological toxicities of any grade with radiation.

HIV infection was a bias on our sample for staging methods and chemotherapy regimens choices. HIV status did not influence on survival when patients were treated with consolidative radiotherapy. RT toxicities were not overall more frequent in the HIV positive population ( p = 0.567), except for fatigue ( p < 0.05) and hematological toxicities ( p = 0.022). CHOP was associated with better survival ( p = 0.015) in the overall population and in the HIV negative population ( p = 0.002), but not in the HIV positive population ( p = 0.982). No HIV positive patient received rituximab due to local policy restrictions and HIV positive patients were more prone to receive CHOP-like chemotherapy ( p < 0.05), specially ones with etoposide (CHOEP). HIV positive patients were more frequently staged only with CT ( p > 0.05) with no impact on PFS ( p = 0.191).

HIV infection had no impact on OS ( p = 0.580) or PFS ( p = 0.347) among patients treated with RT. Median progression-free survival was 48.7 months. Median overall survival was not reached, but mean OS was 50.1 months with 86 deaths. Female patients were 51.3% and most had a good performance in the ECOG scale (78.8% are ECOG 0–1). Twenty-eight patients (7.8%) were HIV positive.

Three-hundred fifty-nine (359) patients were selected, with a median age at diagnosis of 57.7 years (13–90 years). All patients had biopsy-proven lymphoma and were included if radiation was part of the treatment and had at least 6 months of follow-up or were followed until death. Patients and methodsĪ retrospective cohort of all DBCL patients treated with chemotherapy and consolidative radiotherapy at a single institution between 20 was assessed. This article aim to assess that difference that HIV makes on radiation treatment. Even though frequent, it is not known how HIV infection and treatment impact in the consolidation by radiotherapy of non-Hodgkin diffuse large B-cell lymphomas (DBCL).