AIDS-associated non-Hodgkin's lymphoma in San Francisco.
The characteristics of acquired immunodeficiency syndrome-associated non-Hodgkin's lymphoma in 84 patients diagnosed and treated at San Francisco General Hospital are presented herein. While the majority were high-grade B-cell lymphomas, one cutaneous T-cell and one peripheral T-cell lymphoma were observed. In addition, three other tumors were suspicious for T-cell lymphoma. Sixty-seven percent of patients had stage IV disease, often at unusual sites. Epstein-Barr virus DNA sequences were identified in only five of 15 tumors by dot-blot analysis. Patients were treated with a variety of standard chemotherapeutic regimens, with radiation therapy alone, or with a novel chemotherapy protocol (COMET-A). No significant differences in complete response rates were observed. The most important predictor of survival was the total number of CD4-positive lymphocytes. Other predictors of survival included history of a diagnosis of acquired immunodeficiency syndrome, Karnofsky performance score, and the presence of extranodal disease. Survival was shorter among patients who received higher doses of cyclophosphamide (greater than 1 g/m2), including those treated with the COMET-A regimen. Implications for therapeutic decision making are discussed.
Kaplan
L D
LD
Department of Medicine, San Francisco General Hospital, CA 94110.
Abrams
D I
DI
Feigal
E
E
McGrath
M
M
Kahn
J
J
Neville
P
P
Ziegler
J
J
Volberding
P A
PA
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000401:mortality; D000328:Adult; D004854:Herpesvirus 4, Human / Q000276:immunology; D006801:Humans; D008214:Lymphocytes / Q000032:analysis; D008228:Lymphoma, Non-Hodgkin / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012495:San Francisco