title: HIV-associated lymphoma of the gastrointestinal tract: the University of Toronto AIDS-Lymphoma Study Group experience.
abstract: We present a retrospective analysis of 31 (30 male) patients with HIV-associated gastrointestinal lymphoma which was undertaken to determine the natural history and response to therapy. Only seven patients had stage I or II lymphoma and 22 had stage IV. Pathology included diffuse large cell (13), immunoblastic (10), and small cell non-cleaved (7). The median age at presentation was 39 years (range 24-59), and the median CD4 count before treatment was 100/microL (range 4-1150). Eighty-seven percent of patients received systemic chemotherapy and significant response was seen in 84% (CR 38%; PR 46%). Hematologic toxicity was high (febrile neutropenia in 44% and dose reductions were required in 81%) and perforation occurred in five patients. Median survival for all patients was 6 months and death was secondary to lymphoma in 61%, treatment toxicity in 10%, other AIDS-related illnesses in 25% and other causes in 4%. Survival was shorter for patients with bone marrow involvement and for those with poor performance status. HIV-associated GI lymphoma has a poor prognosis despite good initial response to chemotherapy and is associated with a higher perforation rate than in HIV negative patients.
authors.affiliation: Department of Medicine, Toronto Hospital, Ontario, Canada.
authors.forename: K R
authors.initials: KR
authors.lastname: Imrie
authors.forename: C A
authors.initials: CA
authors.lastname: Sawka
authors.forename: G
authors.initials: G
authors.lastname: Kutas
authors.forename: J
authors.initials: J
authors.lastname: Brandwein
authors.forename: E
authors.initials: E
authors.lastname: Warner
authors.forename: R
authors.initials: R
authors.lastname: Burkes
authors.forename: I
authors.initials: I
authors.lastname: Quirt
authors.forename: A
authors.initials: A
authors.lastname: McGeer
authors.forename: F A
authors.initials: FA
authors.lastname: Shepherd
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000453:epidemiology* / Q000628:therapy*; D006801:Humans; D016483:Lymphoma, AIDS-Related / Q000628:therapy; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D011241:Prednisone / Q000008:administration & dosage; D016019:Survival Analysis; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone