{"doi":"10.17615/ds12-1b06","title":"CHOP Chemotherapy for Aggressive Non-Hodgkin Lymphoma with and without HIV in the Antiretroviral Therapy Era in Malawi","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.","journal":"UNC Libraries","year":2020,"id":137434,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8956,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":597416,"name":"Edwards Kasonkanji","orcid":"0000-0002-1543-814X","position":1,"is_corresponding":false},{"id":389600,"name":"Thomas C. Shea","orcid":null,"position":2,"is_corresponding":false},{"id":598032,"name":"Victor Makwakwa","orcid":null,"position":3,"is_corresponding":false},{"id":597415,"name":"Bongani Kaimila","orcid":"0000-0002-9501-7125","position":4,"is_corresponding":false},{"id":598045,"name":"Richard Nyasosela","orcid":null,"position":5,"is_corresponding":false},{"id":598046,"name":"Suzgo Mzumara","orcid":null,"position":6,"is_corresponding":false},{"id":597064,"name":"Coxcilly Kampani","orcid":null,"position":7,"is_corresponding":false},{"id":587626,"name":"Salama Itimu","orcid":null,"position":8,"is_corresponding":false},{"id":598028,"name":"Fred Chimzimu","orcid":null,"position":9,"is_corresponding":false},{"id":597417,"name":"Robert Krysiak","orcid":"0000-0001-5454-2620","position":10,"is_corresponding":false},{"id":597419,"name":"Bal M. Dhungel","orcid":"0000-0003-3132-9370","position":11,"is_corresponding":false},{"id":374516,"name":"Kristy L. Richards","orcid":"0000-0001-5765-6631","position":12,"is_corresponding":false},{"id":597425,"name":"Carlos A. Varela","orcid":"0000-0003-4708-3109","position":13,"is_corresponding":false},{"id":225646,"name":"Nathan D. Montgomery","orcid":"0000-0003-1765-6623","position":14,"is_corresponding":false},{"id":596961,"name":"Agnes Moses","orcid":null,"position":15,"is_corresponding":false},{"id":598033,"name":"N. George Liomba","orcid":null,"position":16,"is_corresponding":false},{"id":598047,"name":"Steve Kamiza","orcid":null,"position":17,"is_corresponding":false},{"id":281459,"name":"Yuri Fedoriw","orcid":"0000-0002-2135-2908","position":18,"is_corresponding":false},{"id":597426,"name":"Tamiwe Tomoka","orcid":"0000-0002-5183-8714","position":19,"is_corresponding":false},{"id":597065,"name":"Maria Chikasema","orcid":null,"position":20,"is_corresponding":false},{"id":281461,"name":"Satish Gopal","orcid":"0000-0003-2314-0316","position":0,"is_corresponding":true}],"reference_count":0,"raw_metadata":null,"created_at":"2026-07-18T23:16:56.001887Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}