Department of Global Health, University of Washington, 901 Boren Avenue, Seattle, WA 98104, United States; Uganda Cancer Institute, Kampala, Uganda; Department of Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, WA, United States; Department of Epidemiology, University of Washington, Seattle, WA, United States
Bateganya, M.H., Department of Global Health, University of Washington, 901 Boren Avenue, Seattle, WA 98104, United States; Stanaway, J., Department of Global Health, University of Washington, 901 Boren Avenue, Seattle, WA 98104, United States, Department of Epidemiology, University of Washington, Seattle, WA, United States; Brentlinger, P.E., Department of Global Health, University of Washington, 901 Boren Avenue, Seattle, WA 98104, United States; Magaret, A.S., Department of Global Health, University of Washington, 901 Boren Avenue, Seattle, WA 98104, United States; Wald, A., Department of Global Health, University of Washington, 901 Boren Avenue, Seattle, WA 98104, United States, Department of Epidemiology, University of Washington, Seattle, WA, United States; Orem, J., Uganda Cancer Institute, Kampala, Uganda; Casper, C., Department of Global Health, University of Washington, 901 Boren Avenue, Seattle, WA 98104, United States, Department of Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
Objective: We examined factors associated with survival among patients with newly diagnosed non-Hodgkin lymphoma (NHL) in Uganda. Methods: Information was abstracted from medical records for all NHL patients >13 years of age at the Uganda Cancer Institute between January 2004 and August 2008. Cox proportional hazard models were used to identify predictors of NHL survival. Results: One hundred sixty patients with NHL were identified; 51 (31.9%) were known to be HIV positive. Overall, 154 patients had records sufficient for further analysis. The median person-time observed was 104 days (interquartile range 26-222). Median survival after presentation among those whose mortality status was confirmed was 61 days (interquartile range 25-203). HIV-positive patients receiving antiretroviral therapy had survival rates approximating those of HIV-negative persons, but the adjusted hazard of death was significantly elevated among HIV-positive patients not receiving antiretroviral therapy [adjusted hazard ratio (HR) 8.99, P < 0.001] compared with HIV-negative patients. Both B-symptoms (HR 2.08, P = 0.05) and female gender (HR 1.72, P = 0.05) were associated with higher mortality. Conclusions: In Uganda, overall survival of NHL patients is poor, and predictors of survival differed from those described in resource-rich regions. HIV is a common comorbidity to NHL, and its lack of treatment was among the strongest predictors of mortality. Strategies are needed for optimal management of HIV-infected individuals with cancer in resource-limited settings. © 2011 Lippincott Williams & Wilkins.
