Stage, serum LDH, and performance status predict disease progression and survival in HIV-associated lymphomas.
OBJECTIVE
This is a review of treatment of 44 patients with positive HIV serology (positive HIV) and lymphoma.


METHODS
Twenty patients had diffuse large-cell lymphoma (DLCL), and 18 had small noncleaved-cell lymphoma (SNCCL). Three had Hodgkin's disease (HD) and 3 had diffuse small- or mixed-cell lymphoma. These patients received intensive chemotherapy regimens for management of their disease; most were regimens in use at our institution for patients with lymphoma who did not have positive HIV.


RESULTS
The complete response to treatment (CR) was 77% for all patient, 80% for those with DLCL, and 72% for those with SNCCL. Stage, serum LDH, and performance status were predictors of complete remission and freedom from progression. Though there was a tendency for patients with a T4-cell count of < or = 200 to have a higher risk of opportunistic infections while receiving therapy, most infections were controllable with appropriate antibiotic management. More than one-half of the deaths in this study occurred after completion of therapy in complete remission, with a median survival of only 11 months, and were attributable to AIDS-related complications.


CONCLUSIONS
Our data suggest that (1) patients with lymphoma who have positive HIV have responses to chemotherapy similar to those expected for patients who are HIV-negative; (2) most infectious complications are manageable with appropriate therapy during treatment; and (3) after completion of chemotherapy, treatment should focus on control of progression of AIDS-related complications.
Hagemeister
F B
FB
Department of Hematology, University of Texas M. D. Anderson Cancer Center, Houston.
Khetan
R
R
Allen
P
P
McLaughlin
P
P
Rodriguez
M A
MA
Swan
F
F
Romaguera
J E
JE
Cabanillas
F
F
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology / Q000209:etiology; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood; D002423:Cause of Death; D003131:Combined Modality Therapy; D005260:Female; D015658:HIV Infections / Q000188:drug therapy; D006689:Hodgkin Disease / Q000097:blood / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood*; D016483:Lymphoma, AIDS-Related / Q000097:blood / Q000145:classification / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000097:blood*; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D011878:Radiotherapy / Q000009:adverse effects; D012074:Remission Induction; D012720:Severity of Illness Index; D016896:Treatment Outcome; D015215:Zidovudine / Q000627:therapeutic use
D014408:Biomarkers, Tumor; D009363:Neoplasm Proteins; D015215:Zidovudine; D007770:L-Lactate Dehydrogenase