Long term follow-up of CEOP in the treatment of HIV related non-Hodgkin's lymphoma (NHL).
BACKGROUND
The development of non-Hodgkin's lymphoma (NHL) in AIDS conveys a poor prognosis with less than 10% of patients surviving beyond two years. These tumours are generally aggressive and often require systemic chemotherapy to bring about effective palliation.


OBJECTIVE
To report on the long term follow-up of patients with HIV related NHL treated with CEOP chemotherapy.


METHODS
This is a retrospective analysis of a group of 18 patients treated at two institutions between October 1990 and 1992 with modified CEOP chemotherapy. Doses were calculated using cyclophosphamide 750 mg/m2, epirubicin 50 mg/m2, vincristine 2 mg and prednisone 75-100 mg x five days, however initial doses of cyclophosphamide and epirubicin were modified to 50-75% of calculated dose.


RESULTS
Seventeen of the 18 patients were male, one female; age range 26-79 (median 36 years); seven with immunoblastic, three Burkitt's, one Ki-1 (anaplastic), six diffuse large cell, and one mixed large and small cell. Eight patients (44%) achieved a complete remission, with seven patients (39%) achieving a partial remission, for an overall response rate of 83% (95% CI = 59-96%). Survival ranged from three-35 months (median nine months). Interestingly, four patients (22%) survived more than two years (median 31 months), three remaining in complete remission at the time of death. Generally therapy was well tolerated and toxicity was manageable.


CONCLUSIONS
CEOP is an effective, tolerable and safe regimen and our long term follow-up suggests that there is a small sub-population of patients with HIV and lymphoma who may have a better prognosis and as such would clearly benefit from systemic chemotherapy as a means of prolonging survival and not simply palliation.
Davis
A J
AJ
Prince of Wales Hospital, Sydney, NSW.
Goldstein
D
D
Milliken
S
S
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000627:therapeutic use; D015251:Epirubicin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016483:Lymphoma, AIDS-Related / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D011241:Prednisone / Q000627:therapeutic use; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D014750:Vincristine / Q000627:therapeutic use
D015251:Epirubicin; D014750:Vincristine; D003520:Cyclophosphamide; D011241:Prednisone