{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T07:39:17Z","timestamp":1773387557212,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"19","license":[{"start":{"date-parts":[[2020,8,13]],"date-time":"2020-08-13T00:00:00Z","timestamp":1597276800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>For patients with diffuse large B\u2010cell lymphoma (DLBCL), standard\u2010care is rituximab administered with CHOP or CHOP\u2010like chemotherapy (R\u2010CHOP). However, the effectiveness and safety of R\u2010CHOP among DLBCL patients with human immunodeficiency virus (HIV) infection is less clear, as HIV+ patients were omitted from most clinical trials and population\u2010level data from unselected patients are limited. R\u2010CHOP was funded for HIV\u2010associated DLBCL patients with CD4 &gt;50\/mm<jats:sup>3<\/jats:sup> in Ontario in February 2015.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with a new diagnosis of DLBCL were identified from the Ontario Cancer Registry between April 2010 and March 2018. HIV diagnosis and chemotherapy regimen were ascertained using administrative databases at Ontario Health. The effect of rituximab and HIV on overall survival was assessed in the HIV+ subgroup (R\u2010CHOP vs CHOP) and in the R\u2010CHOP subgroup (HIV+ vs HIV\u2212).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among HIV+ patients, receipt of R\u2010CHOP was associated with a fivefold improvement in overall survival (hazard ratio [HR] 0.29 (0.13\u20100.66) compared with CHOP), after adjustment. Among patients who received R\u2010CHOP (n\u00a0=\u00a06106), older age, male sex, lower neighborhood income, and higher comorbidity were associated with worse overall survival, after adjustment (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001 for all), but HIV positivity was not prognostic (HR 1.12 (0.60\u20102.10)). Within 1\u2010year after diagnosis, HIV+ patients receiving R\u2010CHOP had a similar proportion of patients who visited the emergency department (67% vs 66% <jats:italic>P<\/jats:italic>\u00a0=\u00a0.43) or admitted to hospital (58% vs 52%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.43) and as HIV\u2212 patients receiving R\u2010CHOP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>HIV status did not affect prognosis for patients with DLBCL receiving R\u2010CHOP in an unselected general population when rituximab was used according to funding criteria. R\u2010CHOP was safe and effective for DLBCL treatment, regardless of HIV status.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.3362","type":"journal-article","created":{"date-parts":[[2020,8,14]],"date-time":"2020-08-14T14:18:22Z","timestamp":1597414702000},"page":"7072-7082","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The effectiveness of rituximab and HIV on the survival of Ontario patients with diffuse large B\u2010cell lymphoma"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9650-9105","authenticated-orcid":false,"given":"Steven","family":"Habbous","sequence":"first","affiliation":[{"name":"Ontario Health (Cancer Care Ontario) Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen","family":"Guo","sequence":"additional","affiliation":[{"name":"Ontario Health (Cancer Care Ontario) Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8858-9566","authenticated-orcid":false,"given":"Jaclyn","family":"Beca","sequence":"additional","affiliation":[{"name":"Ontario Health (Cancer Care Ontario) Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1416-1070","authenticated-orcid":false,"given":"Wei Fang","family":"Dai","sequence":"additional","affiliation":[{"name":"Ontario Health (Cancer Care Ontario) Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8368-6065","authenticated-orcid":false,"given":"Wanrudee","family":"Isaranuwatchai","sequence":"additional","affiliation":[{"name":"Centre for Excellence in Economic Analysis Research St. Michael's Hospital Toronto ON Canada"},{"name":"Canadian Centre for Applied Research in Cancer Control Toronto ON Canada"},{"name":"Institute of Health Policy, Management and Evaluation Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3193-5872","authenticated-orcid":false,"given":"Matthew","family":"Cheung","sequence":"additional","affiliation":[{"name":"Hematology Sunnybrook Health Sciences Centre Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2501-3057","authenticated-orcid":false,"given":"Kelvin K. 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