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Gupta NK, Nolan A, Omuro A, Reid EG, Wang CC, Mannis G, Jaglal M, Chavez JC, Rubinstein PG, Griffin A, Abrams DI, Hwang J, Kaplan LD, Luce JA, Volberding P, Treseler PA, Rubenstein JL. Long-term survival in AIDS-related primary central nervous system lymphoma. Neuro Oncol 2016; 19:99-108. [PMID: 27576871 DOI: 10.1093/neuonc/now155] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The optimal therapeutic approach for patients with AIDS-related primary central nervous system lymphoma (AR-PCNSL) remains undefined. While its incidence declined substantially with combination antiretroviral therapy (cART), AR-PCNSL remains a highly aggressive neoplasm for which whole brain radiotherapy (WBRT) is considered a standard first-line intervention. METHODS To identify therapy-related factors associated with favorable survival, we first retrospectively analyzed outcomes of AR-PCNSL patients treated at San Francisco General Hospital, a public hospital with a long history of dedicated care for patients with HIV and AIDS-related malignancies. Results were validated in a retrospective, multicenter analysis that evaluated all newly diagnosed patients with AR-PCNSL treated with cART plus high-dose methotrexate (HD-MTX). RESULTS We provide evidence that CD4+ reconstitution with cART administered during HD-MTX correlates with long-term survival among patients with CD4 <100. This was confirmed in a multicenter analysis which demonstrated that integration of cART regimens with HD-MTX was generally well tolerated and resulted in longer progression-free survival than other treatments. No profound differences in immunophenotype were identified in an analysis of AR-PCNSL tumors that arose in the pre- versus post-cART eras. However, we detected evidence for a demographic shift, as the proportion of minority patients with AR-PCNSL increased since advent of cART. CONCLUSION Long-term disease-free survival can be achieved in AR-PCNSL, even among those with histories of opportunistic infections, limited access to health care, and medical non-adherence. Given this, as well as the long-term toxicities of WBRT, we recommend that integration of cART plus first-line HD-MTX be considered for all patients with AR-PCNSL.
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Affiliation(s)
- Neel K Gupta
- Division of Hematology/Oncology, University of California, San Francisco (N.K.G., C.W., G.M., D.I.A., L.D.K., J.A.L., P.V., J.L.R.); Department of Pathology, University of California, San Francisco (A.N., P.A.T.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY (A.O.); Division of Hematology/Oncology, University of California, San Diego (E.G.R.); Division of Hematology/Oncology, San Francisco General Hospital (C.W., D.I.A., J.A.L.); Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL (M.J., J.C.C.); Department of Medicine, Section of Hematology/Oncology, John H. Stroger Jr. Hospital of Cook County, Ruth M. Rothstein CORE Center, Developmental Center for AIDS Research, Chicago, IL (P.G.R.); Department of Internal Medicine, Rush University Medical Center, Chicago, IL (P.G.R.); UCSF Cancer Registry, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (A.G.); Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (D.I.A., J.H., L.D.K., J.A.L., P.V., P.A.T., J.L.R.); Biostatistics and Computational Biology Core, UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (J.H.); Center for AIDS Research; UCSF Gladstone Institute of Virology and Immunology (P.V.)
| | - Amber Nolan
- Division of Hematology/Oncology, University of California, San Francisco (N.K.G., C.W., G.M., D.I.A., L.D.K., J.A.L., P.V., J.L.R.); Department of Pathology, University of California, San Francisco (A.N., P.A.T.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY (A.O.); Division of Hematology/Oncology, University of California, San Diego (E.G.R.); Division of Hematology/Oncology, San Francisco General Hospital (C.W., D.I.A., J.A.L.); Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL (M.J., J.C.C.); Department of Medicine, Section of Hematology/Oncology, John H. Stroger Jr. Hospital of Cook County, Ruth M. Rothstein CORE Center, Developmental Center for AIDS Research, Chicago, IL (P.G.R.); Department of Internal Medicine, Rush University Medical Center, Chicago, IL (P.G.R.); UCSF Cancer Registry, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (A.G.); Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (D.I.A., J.H., L.D.K., J.A.L., P.V., P.A.T., J.L.R.); Biostatistics and Computational Biology Core, UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (J.H.); Center for AIDS Research; UCSF Gladstone Institute of Virology and Immunology (P.V.)
| | - Antonio Omuro
- Division of Hematology/Oncology, University of California, San Francisco (N.K.G., C.W., G.M., D.I.A., L.D.K., J.A.L., P.V., J.L.R.); Department of Pathology, University of California, San Francisco (A.N., P.A.T.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY (A.O.); Division of Hematology/Oncology, University of California, San Diego (E.G.R.); Division of Hematology/Oncology, San Francisco General Hospital (C.W., D.I.A., J.A.L.); Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL (M.J., J.C.C.); Department of Medicine, Section of Hematology/Oncology, John H. Stroger Jr. Hospital of Cook County, Ruth M. Rothstein CORE Center, Developmental Center for AIDS Research, Chicago, IL (P.G.R.); Department of Internal Medicine, Rush University Medical Center, Chicago, IL (P.G.R.); UCSF Cancer Registry, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (A.G.); Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (D.I.A., J.H., L.D.K., J.A.L., P.V., P.A.T., J.L.R.); Biostatistics and Computational Biology Core, UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (J.H.); Center for AIDS Research; UCSF Gladstone Institute of Virology and Immunology (P.V.)
| | - Erin G Reid
- Division of Hematology/Oncology, University of California, San Francisco (N.K.G., C.W., G.M., D.I.A., L.D.K., J.A.L., P.V., J.L.R.); Department of Pathology, University of California, San Francisco (A.N., P.A.T.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY (A.O.); Division of Hematology/Oncology, University of California, San Diego (E.G.R.); Division of Hematology/Oncology, San Francisco General Hospital (C.W., D.I.A., J.A.L.); Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL (M.J., J.C.C.); Department of Medicine, Section of Hematology/Oncology, John H. Stroger Jr. Hospital of Cook County, Ruth M. Rothstein CORE Center, Developmental Center for AIDS Research, Chicago, IL (P.G.R.); Department of Internal Medicine, Rush University Medical Center, Chicago, IL (P.G.R.); UCSF Cancer Registry, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (A.G.); Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (D.I.A., J.H., L.D.K., J.A.L., P.V., P.A.T., J.L.R.); Biostatistics and Computational Biology Core, UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (J.H.); Center for AIDS Research; UCSF Gladstone Institute of Virology and Immunology (P.V.)
| | - Chia-Ching Wang
- Division of Hematology/Oncology, University of California, San Francisco (N.K.G., C.W., G.M., D.I.A., L.D.K., J.A.L., P.V., J.L.R.); Department of Pathology, University of California, San Francisco (A.N., P.A.T.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY (A.O.); Division of Hematology/Oncology, University of California, San Diego (E.G.R.); Division of Hematology/Oncology, San Francisco General Hospital (C.W., D.I.A., J.A.L.); Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL (M.J., J.C.C.); Department of Medicine, Section of Hematology/Oncology, John H. Stroger Jr. Hospital of Cook County, Ruth M. Rothstein CORE Center, Developmental Center for AIDS Research, Chicago, IL (P.G.R.); Department of Internal Medicine, Rush University Medical Center, Chicago, IL (P.G.R.); UCSF Cancer Registry, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (A.G.); Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (D.I.A., J.H., L.D.K., J.A.L., P.V., P.A.T., J.L.R.); Biostatistics and Computational Biology Core, UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (J.H.); Center for AIDS Research; UCSF Gladstone Institute of Virology and Immunology (P.V.)
| | - Gabriel Mannis
- Division of Hematology/Oncology, University of California, San Francisco (N.K.G., C.W., G.M., D.I.A., L.D.K., J.A.L., P.V., J.L.R.); Department of Pathology, University of California, San Francisco (A.N., P.A.T.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY (A.O.); Division of Hematology/Oncology, University of California, San Diego (E.G.R.); Division of Hematology/Oncology, San Francisco General Hospital (C.W., D.I.A., J.A.L.); Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL (M.J., J.C.C.); Department of Medicine, Section of Hematology/Oncology, John H. Stroger Jr. Hospital of Cook County, Ruth M. Rothstein CORE Center, Developmental Center for AIDS Research, Chicago, IL (P.G.R.); Department of Internal Medicine, Rush University Medical Center, Chicago, IL (P.G.R.); UCSF Cancer Registry, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (A.G.); Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (D.I.A., J.H., L.D.K., J.A.L., P.V., P.A.T., J.L.R.); Biostatistics and Computational Biology Core, UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (J.H.); Center for AIDS Research; UCSF Gladstone Institute of Virology and Immunology (P.V.)
| | - Michael Jaglal
- Division of Hematology/Oncology, University of California, San Francisco (N.K.G., C.W., G.M., D.I.A., L.D.K., J.A.L., P.V., J.L.R.); Department of Pathology, University of California, San Francisco (A.N., P.A.T.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY (A.O.); Division of Hematology/Oncology, University of California, San Diego (E.G.R.); Division of Hematology/Oncology, San Francisco General Hospital (C.W., D.I.A., J.A.L.); Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL (M.J., J.C.C.); Department of Medicine, Section of Hematology/Oncology, John H. Stroger Jr. Hospital of Cook County, Ruth M. Rothstein CORE Center, Developmental Center for AIDS Research, Chicago, IL (P.G.R.); Department of Internal Medicine, Rush University Medical Center, Chicago, IL (P.G.R.); UCSF Cancer Registry, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (A.G.); Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (D.I.A., J.H., L.D.K., J.A.L., P.V., P.A.T., J.L.R.); Biostatistics and Computational Biology Core, UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (J.H.); Center for AIDS Research; UCSF Gladstone Institute of Virology and Immunology (P.V.)
| | - Julio C Chavez
- Division of Hematology/Oncology, University of California, San Francisco (N.K.G., C.W., G.M., D.I.A., L.D.K., J.A.L., P.V., J.L.R.); Department of Pathology, University of California, San Francisco (A.N., P.A.T.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY (A.O.); Division of Hematology/Oncology, University of California, San Diego (E.G.R.); Division of Hematology/Oncology, San Francisco General Hospital (C.W., D.I.A., J.A.L.); Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL (M.J., J.C.C.); Department of Medicine, Section of Hematology/Oncology, John H. Stroger Jr. Hospital of Cook County, Ruth M. Rothstein CORE Center, Developmental Center for AIDS Research, Chicago, IL (P.G.R.); Department of Internal Medicine, Rush University Medical Center, Chicago, IL (P.G.R.); UCSF Cancer Registry, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (A.G.); Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (D.I.A., J.H., L.D.K., J.A.L., P.V., P.A.T., J.L.R.); Biostatistics and Computational Biology Core, UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (J.H.); Center for AIDS Research; UCSF Gladstone Institute of Virology and Immunology (P.V.)
| | - Paul G Rubinstein
- Division of Hematology/Oncology, University of California, San Francisco (N.K.G., C.W., G.M., D.I.A., L.D.K., J.A.L., P.V., J.L.R.); Department of Pathology, University of California, San Francisco (A.N., P.A.T.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY (A.O.); Division of Hematology/Oncology, University of California, San Diego (E.G.R.); Division of Hematology/Oncology, San Francisco General Hospital (C.W., D.I.A., J.A.L.); Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL (M.J., J.C.C.); Department of Medicine, Section of Hematology/Oncology, John H. Stroger Jr. Hospital of Cook County, Ruth M. Rothstein CORE Center, Developmental Center for AIDS Research, Chicago, IL (P.G.R.); Department of Internal Medicine, Rush University Medical Center, Chicago, IL (P.G.R.); UCSF Cancer Registry, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (A.G.); Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (D.I.A., J.H., L.D.K., J.A.L., P.V., P.A.T., J.L.R.); Biostatistics and Computational Biology Core, UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (J.H.); Center for AIDS Research; UCSF Gladstone Institute of Virology and Immunology (P.V.)
| | - Ann Griffin
- Division of Hematology/Oncology, University of California, San Francisco (N.K.G., C.W., G.M., D.I.A., L.D.K., J.A.L., P.V., J.L.R.); Department of Pathology, University of California, San Francisco (A.N., P.A.T.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY (A.O.); Division of Hematology/Oncology, University of California, San Diego (E.G.R.); Division of Hematology/Oncology, San Francisco General Hospital (C.W., D.I.A., J.A.L.); Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL (M.J., J.C.C.); Department of Medicine, Section of Hematology/Oncology, John H. Stroger Jr. Hospital of Cook County, Ruth M. Rothstein CORE Center, Developmental Center for AIDS Research, Chicago, IL (P.G.R.); Department of Internal Medicine, Rush University Medical Center, Chicago, IL (P.G.R.); UCSF Cancer Registry, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (A.G.); Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (D.I.A., J.H., L.D.K., J.A.L., P.V., P.A.T., J.L.R.); Biostatistics and Computational Biology Core, UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (J.H.); Center for AIDS Research; UCSF Gladstone Institute of Virology and Immunology (P.V.)
| | - Donald I Abrams
- Division of Hematology/Oncology, University of California, San Francisco (N.K.G., C.W., G.M., D.I.A., L.D.K., J.A.L., P.V., J.L.R.); Department of Pathology, University of California, San Francisco (A.N., P.A.T.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY (A.O.); Division of Hematology/Oncology, University of California, San Diego (E.G.R.); Division of Hematology/Oncology, San Francisco General Hospital (C.W., D.I.A., J.A.L.); Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL (M.J., J.C.C.); Department of Medicine, Section of Hematology/Oncology, John H. Stroger Jr. Hospital of Cook County, Ruth M. Rothstein CORE Center, Developmental Center for AIDS Research, Chicago, IL (P.G.R.); Department of Internal Medicine, Rush University Medical Center, Chicago, IL (P.G.R.); UCSF Cancer Registry, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (A.G.); Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (D.I.A., J.H., L.D.K., J.A.L., P.V., P.A.T., J.L.R.); Biostatistics and Computational Biology Core, UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (J.H.); Center for AIDS Research; UCSF Gladstone Institute of Virology and Immunology (P.V.)
| | - Jimmy Hwang
- Division of Hematology/Oncology, University of California, San Francisco (N.K.G., C.W., G.M., D.I.A., L.D.K., J.A.L., P.V., J.L.R.); Department of Pathology, University of California, San Francisco (A.N., P.A.T.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY (A.O.); Division of Hematology/Oncology, University of California, San Diego (E.G.R.); Division of Hematology/Oncology, San Francisco General Hospital (C.W., D.I.A., J.A.L.); Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL (M.J., J.C.C.); Department of Medicine, Section of Hematology/Oncology, John H. Stroger Jr. Hospital of Cook County, Ruth M. Rothstein CORE Center, Developmental Center for AIDS Research, Chicago, IL (P.G.R.); Department of Internal Medicine, Rush University Medical Center, Chicago, IL (P.G.R.); UCSF Cancer Registry, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (A.G.); Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (D.I.A., J.H., L.D.K., J.A.L., P.V., P.A.T., J.L.R.); Biostatistics and Computational Biology Core, UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (J.H.); Center for AIDS Research; UCSF Gladstone Institute of Virology and Immunology (P.V.)
| | - Lawrence D Kaplan
- Division of Hematology/Oncology, University of California, San Francisco (N.K.G., C.W., G.M., D.I.A., L.D.K., J.A.L., P.V., J.L.R.); Department of Pathology, University of California, San Francisco (A.N., P.A.T.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY (A.O.); Division of Hematology/Oncology, University of California, San Diego (E.G.R.); Division of Hematology/Oncology, San Francisco General Hospital (C.W., D.I.A., J.A.L.); Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL (M.J., J.C.C.); Department of Medicine, Section of Hematology/Oncology, John H. Stroger Jr. Hospital of Cook County, Ruth M. Rothstein CORE Center, Developmental Center for AIDS Research, Chicago, IL (P.G.R.); Department of Internal Medicine, Rush University Medical Center, Chicago, IL (P.G.R.); UCSF Cancer Registry, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (A.G.); Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (D.I.A., J.H., L.D.K., J.A.L., P.V., P.A.T., J.L.R.); Biostatistics and Computational Biology Core, UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (J.H.); Center for AIDS Research; UCSF Gladstone Institute of Virology and Immunology (P.V.)
| | - Judith A Luce
- Division of Hematology/Oncology, University of California, San Francisco (N.K.G., C.W., G.M., D.I.A., L.D.K., J.A.L., P.V., J.L.R.); Department of Pathology, University of California, San Francisco (A.N., P.A.T.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY (A.O.); Division of Hematology/Oncology, University of California, San Diego (E.G.R.); Division of Hematology/Oncology, San Francisco General Hospital (C.W., D.I.A., J.A.L.); Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL (M.J., J.C.C.); Department of Medicine, Section of Hematology/Oncology, John H. Stroger Jr. Hospital of Cook County, Ruth M. Rothstein CORE Center, Developmental Center for AIDS Research, Chicago, IL (P.G.R.); Department of Internal Medicine, Rush University Medical Center, Chicago, IL (P.G.R.); UCSF Cancer Registry, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (A.G.); Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (D.I.A., J.H., L.D.K., J.A.L., P.V., P.A.T., J.L.R.); Biostatistics and Computational Biology Core, UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (J.H.); Center for AIDS Research; UCSF Gladstone Institute of Virology and Immunology (P.V.)
| | - Paul Volberding
- Division of Hematology/Oncology, University of California, San Francisco (N.K.G., C.W., G.M., D.I.A., L.D.K., J.A.L., P.V., J.L.R.); Department of Pathology, University of California, San Francisco (A.N., P.A.T.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY (A.O.); Division of Hematology/Oncology, University of California, San Diego (E.G.R.); Division of Hematology/Oncology, San Francisco General Hospital (C.W., D.I.A., J.A.L.); Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL (M.J., J.C.C.); Department of Medicine, Section of Hematology/Oncology, John H. Stroger Jr. Hospital of Cook County, Ruth M. Rothstein CORE Center, Developmental Center for AIDS Research, Chicago, IL (P.G.R.); Department of Internal Medicine, Rush University Medical Center, Chicago, IL (P.G.R.); UCSF Cancer Registry, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (A.G.); Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (D.I.A., J.H., L.D.K., J.A.L., P.V., P.A.T., J.L.R.); Biostatistics and Computational Biology Core, UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (J.H.); Center for AIDS Research; UCSF Gladstone Institute of Virology and Immunology (P.V.)
| | - Patrick A Treseler
- Division of Hematology/Oncology, University of California, San Francisco (N.K.G., C.W., G.M., D.I.A., L.D.K., J.A.L., P.V., J.L.R.); Department of Pathology, University of California, San Francisco (A.N., P.A.T.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY (A.O.); Division of Hematology/Oncology, University of California, San Diego (E.G.R.); Division of Hematology/Oncology, San Francisco General Hospital (C.W., D.I.A., J.A.L.); Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL (M.J., J.C.C.); Department of Medicine, Section of Hematology/Oncology, John H. Stroger Jr. Hospital of Cook County, Ruth M. Rothstein CORE Center, Developmental Center for AIDS Research, Chicago, IL (P.G.R.); Department of Internal Medicine, Rush University Medical Center, Chicago, IL (P.G.R.); UCSF Cancer Registry, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (A.G.); Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (D.I.A., J.H., L.D.K., J.A.L., P.V., P.A.T., J.L.R.); Biostatistics and Computational Biology Core, UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (J.H.); Center for AIDS Research; UCSF Gladstone Institute of Virology and Immunology (P.V.)
| | - James L Rubenstein
- Division of Hematology/Oncology, University of California, San Francisco (N.K.G., C.W., G.M., D.I.A., L.D.K., J.A.L., P.V., J.L.R.); Department of Pathology, University of California, San Francisco (A.N., P.A.T.); Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY (A.O.); Division of Hematology/Oncology, University of California, San Diego (E.G.R.); Division of Hematology/Oncology, San Francisco General Hospital (C.W., D.I.A., J.A.L.); Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL (M.J., J.C.C.); Department of Medicine, Section of Hematology/Oncology, John H. Stroger Jr. Hospital of Cook County, Ruth M. Rothstein CORE Center, Developmental Center for AIDS Research, Chicago, IL (P.G.R.); Department of Internal Medicine, Rush University Medical Center, Chicago, IL (P.G.R.); UCSF Cancer Registry, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (A.G.); Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (D.I.A., J.H., L.D.K., J.A.L., P.V., P.A.T., J.L.R.); Biostatistics and Computational Biology Core, UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (J.H.); Center for AIDS Research; UCSF Gladstone Institute of Virology and Immunology (P.V.)
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