ArticlePloS one2016
CHOP Chemotherapy for Aggressive Non-Hodgkin Lymphoma with and without HIV in the Antiretroviral Therapy Era in Malawi.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers.
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Who cites it
36 citing papers in PubMed, 52 citations in OpenAlex.
- Rituximab is associated with an increased risk of malaria among adult lymphoma patients in Malawi: a prospective observational cohort.EClinicalMedicine · 2025Article
- Article
- Aetiology, susceptibility and outcomes of fever in patients receiving chemotherapy in Malawi: a prospective study.JAC-antimicrobial resistance · 2024Article
- HIV and prior exposure to antiretroviral therapy alter tumour composition and tumour: T-cell associations in diffuse large B-cell lymphoma.British journal of haematology · 2024Article
- State of the science and future directions for research on HIV and cancer: Summary of a joint workshop sponsored by IARC and NCI.International journal of cancer · 2024Review
- Update on pathology laboratory development and research in advancing regional cancer care in Malawi.Frontiers in medicine · 2024Article
- Guideline Concordance of Treatment and Outcomes Among Adult Non-Hodgkin Lymphoma Patients in Sub-Saharan Africa: A Multinational, Population-Based Cohort.The oncologist · 2023Article
- Diffuse Large B-Cell Lymphoma Treated With R-CHOP in a Resource-Limited Setting in South Africa: A Real-World Study.The oncologist · 2023Article
- Cancer-Related Stigma in Malawi: Narratives of Cancer Survivors.JCO global oncology · 2023Article
- Kusankha Pamodzi: Health Care Decision-Making Preferences Among Patients with Cancer in Malawi.Palliative medicine reports · 2023Article
- Implementation and Evaluation of Educational Videos to Improve Cancer Knowledge and Patient Empowerment.JCO global oncology · 2022Article
- Comparison of baseline lymphoma and HIV characteristics in Malawi before and after implementation of universal antiretroviral therapy.PloS one · 2022Observational
- Chronic viral hepatitis, HIV infection and Non-Hodgkin lymphomas in West Africa, a case-control study.International journal of cancer · 2021Article
- Accuracy of Pathologic Diagnosis in Patients With Lymphoma and Survival: A Prospective Analysis From Botswana.JCO global oncology · 2021Article
- Feasibility of upfront mobile money transfers for transportation reimbursement to promote retention among patients receiving lymphoma treatment in Malawi.International health · 2021Article
- Epidemiology of haematological malignancies in people living with HIV.The lancet. HIV · 2020Review
- Outcomes of treatment with CHOP and EPOCH in patients with HIV associated NHL in a low resource setting.BMC cancer · 2020Article
- Identifying transcriptional profiles and evaluating prognostic biomarkers of HIV-associated diffuse large B-cell lymphoma from Malawi.Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2020Observational
- Challenges of HIV Lymphoma Clinical Trials in Africa: Lessons From the AIDS Malignancy Consortium 068 Study.JCO global oncology · 2020Article
- High pretreatment plasma Epstein-Barr virus (EBV) DNA level is a poor prognostic marker in HIV-associated, EBV-negative diffuse large B-cell lymphoma in Malawi.Cancer medicine · 2020Observational
Corrections and comments
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Authors and funding
21 authors at 5 institutions in 2 countries.
Funding
Abstract
There are no prospective studies of aggressive non-Hodgkin lymphoma (NHL) treated with CHOP in sub-Saharan Africa. We enrolled adults with aggressive NHL in Malawi between June 2013 and May 2015. Chemotherapy and supportive care were standardized, and HIV+ patients received antiretroviral therapy (ART). Thirty-seven of 58 patients (64%) were HIV+. Median age was 47 years (IQR 39-56), and 35 (60%) were male. Thirty-five patients (60%) had stage III/IV, 43 (74%) B symptoms, and 28 (48%) performance status ≥ 2. B-cell NHL predominated among HIV+ patients, and all T-cell NHL occurred among HIV- individuals. Thirty-one HIV+ patients (84%) were on ART for a median 9.9 months (IQR 1.1-31.7) before NHL diagnosis, median CD4 was 121 cells/μL (IQR 61-244), and 43% had suppressed HIV RNA. HIV+ patients received a similar number of CHOP cycles compared to HIV- patients, but more frequently developed grade 3/4 neutropenia (84% vs 31%, p = 0.001), resulting in modestly lower cyclophosphamide and doxorubicin doses with longer intervals between cycles. Twelve-month overall survival (OS) was 45% (95% CI 31-57%). T-cell NHL (HR 3.90, p = 0.017), hemoglobin (HR 0.82 per g/dL, p = 0.017), albumin (HR 0.57 per g/dL, p = 0.019), and IPI (HR 2.02 per unit, p<0.001) were associated with mortality. HIV was not associated with mortality, and findings were similar among patients with diffuse large B-cell lymphoma. Twenty-three deaths were from NHL (12 HIV+, 11 HIV-), and 12 from CHOP (9 HIV+, 3 HIV-). CHOP can be safe, effective, and feasible for aggressive NHL in Malawi with and without HIV.
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