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Physician perceptions and preferences in the treatment of acquired immunodeficiency syndrome (AIDS)-related lymphoma

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Abstract

The optimal management of acquired immunodeficiency syndrome-related lymphoma (ARL) in the era of combination antiretroviral therapy (cART) is unclear. We administered a survey to determine physician preferences and perceptions in the management of ARL and to assess the variability in treatment in Canada. Of 196 lymphoma-treating physicians, 117 (63%) responded. The majority of respondents (98%) had a positive attitude towards the treatment of ARL. Most physicians (66%) recommended the concomitant use of cART in the care of their patients with ARL, and a majority (86%) recommended CHOP-like regimens (cyclophosphamide, doxorubicin, vincristine, and prednisone) to form the backbone of chemotherapy. The addition of rituximab was preferred by 43% of physicians, while 39% and 18% would either not use rituximab or were unsure of the agent’s role, respectively. In logistic regression analysis, use of rituximab was predicted only by location of practice (province); physicians from the province of British Colombia were much more likely to administer rituximab than practitioners from Ontario (odds ratio 41.8; 95% confidence interval 7.44–235.1, p < 0.001). In the current cART era, physicians have a positive attitude towards the treatment of ARL. The majority prefer to use cART in combination with CHOP for ARL. The use and perceived benefit of rituximab may be influenced by interprovincial formulary differences and regional variation in guideline recommendations.

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Acknowledgement

This study was funded by the Canadian Foundation for AIDS Research (CANFAR grant #018-116). Dr. Cheung receives funding from a Canadian Institutes of Health Research (CIHR) HIV/AIDS Fellowship. We acknowledge the generous contribution of the physicians who agreed to participate in our survey study and we are grateful to Dr. E. Francis Cook for his guidance and mentorship during the research process.

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Authors and Affiliations

  1. Department of Medicine, Division of Hematology/Medical Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada

    Matthew C. Cheung, Kevin R. Imrie & Rena Buckstein

  2. Department of Medicine, Division of Hematology, St. Paul’s Hospital, University of British Columbia, Vancouver, BC, Canada

    Heather A. Leitch

  3. Department of Family and Community Medicine, St. Michael’s Hospital, University of Toronto, Toronto, ON, Canada

    Laura Y. Park-Wyllie & Tony Antoniou

  4. Centre for Research on Inner City Health, St. Michael’s Hospital, University of Toronto, Toronto, ON, Canada

    Laura Y. Park-Wyllie

  5. Department of Medicine, Division of Infectious Diseases, Maple Leaf Medical Clinic, University of Toronto, Toronto, ON, Canada

    Mona R. Loutfy

  6. Department of Medicine, Division of Hematology/Medical Oncology, Toronto Sunnybrook Regional Cancer Centre, 2075 Bayview Avenue, T2-031, Toronto, M4N 3M5, ON, Canada

    Matthew C. Cheung

Authors
  1. Matthew C. Cheung
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  2. Kevin R. Imrie
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  3. Heather A. Leitch
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  4. Laura Y. Park-Wyllie
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  5. Rena Buckstein
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  6. Tony Antoniou
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  7. Mona R. Loutfy
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Correspondence to Matthew C. Cheung.

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Cheung, M.C., Imrie, K.R., Leitch, H.A. et al. Physician perceptions and preferences in the treatment of acquired immunodeficiency syndrome (AIDS)-related lymphoma. Ann Hematol 86, 631–638 (2007). https://doi.org/10.1007/s00277-007-0284-8

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  • DOI: https://doi.org/10.1007/s00277-007-0284-8

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