title: [Successful treatment with hyper-CVAD and highly active anti-retroviral therapy (HAART) for AIDS-related Burkitt lymphoma].
abstract: A 38-year-old man was admitted to our hospital because of continuous fever and right facial palsy. He was diagnosed as HIV positive. Abdominal CT scan showed a large mass in the ascending colon. Gallium scintigraphy demonstrated increased uptake in the ascending colon. Colonoscopy was performed and histological examination of the colon tumor revealed Burkitt's lymphoma (BL). He received highly active anti-retroviral therapy (HAART) and his facial palsy improved. Because CD4 count was significantly low at 31/microl, he was treated with dose-adjusted EPOCH (DA-EPOCH) combined with HAART. Although the tumor was decreased in size by DA-EPOCH, we changed to the combination of hyper-CVAD/MTX-Ara-C alternating therapy with HAART in order to increase dose intensity. Six cycles of hyper-CVAD/MTX-Ara-C were performed and complete remission was obtained. In the HAART era, the survival of patients with AIDS-related diffuse large cell lymphoma (DLCL) improved dramatically, whereas the survival of similarly treated patients with AIDS-related BL remained poor. Our case suggests that intensive chemotherapy with hyper-CVAD/MTX-Ara-C combined with HAART may be well tolerated and effective in AIDS-related BL.
authors.affiliation: Department of Hematology, Yokohama Municipal Citizen's Hospital, Japan.
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Suzuki
authors.forename: Tomonori
authors.initials: T
authors.lastname: Nakazato
authors.forename: Yukinari
authors.initials: Y
authors.lastname: Sanada
authors.forename: Ai
authors.initials: A
authors.lastname: Mihara
authors.forename: Natsuo
authors.initials: N
authors.lastname: Tachikawa
authors.forename: Hanako
authors.initials: H
authors.lastname: Kurai
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Yoshimura
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Hayashi
authors.forename: Sachiko
authors.initials: S
authors.lastname: Yoshida
authors.forename: Tsunayuki
authors.initials: T
authors.lastname: Kakimoto
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D002051:Burkitt Lymphoma / Q000175:diagnosis / Q000188:drug therapy*; D003110:Colonic Neoplasms / Q000175:diagnosis / Q000188:drug therapy*; D003520:Cyclophosphamide / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D016483:Lymphoma, AIDS-Related / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D011241:Prednisone / Q000008:administration & dosage; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D003561:Cytarabine; D014750:Vincristine; D005047:Etoposide; D003907:Dexamethasone; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone; D008727:Methotrexate