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Long-term, disease free survival in AIDS-related lymphoma (AIDS-NHL) (Meeting abstract).
Mocharnuk RS; Ghadialy A; Tulpule A; Espina B; Levine AM; USC School of
February 28, 1997
Proc Annu Meet Am Soc Clin Oncol; 15:A855 1996. Unique Identifier :

Although lymphoma comprises approximately 3% of all initial AIDS defining illnesses, it is the cause of death in approximately 16% of AIDS patients. Lymphoma is thus felt to represent a late manifestation of HIV disease, with increasing numbers of patients expected as survival with HIV is prolonged. While advances in the therapy of systemic AIDS-related lymphoma have been made, characterization of long-term survivors has not yet been accomplished. In an attempt to ascertain those parameters associated with long-term survival after AIDS-related lymphoma, we reviewed the records of 175 patients, treated at the USC School of Medicine since 1982. Twenty-one patients met our criteria of disease free survival for at least 2 years after diagnosis and therapy of AIDS-NHL. The median age was 40 yr (22 to 55). There were 20 males and 1 female. Risk for HIV included homosexuality in 19; transfusion in 1; injection drug use in 1. Median CD4 cells at NHL dx was 237 (range 5-700), with CD4 less than 50 in 4 (19%); CD4 less than 100 in 5 (24%); CD4 less than 200 in 9 (43%). Opportunistic infections prior to NHL were diagnosed in 3, while the others had no prior AIDS illness. Pathology of NHL included high grade in 17, intermediate grade large cell diffuse in 4. Systemic 'B' sxs were present in 8 (31%). Stage IV NHL was found in 13 (62%), with CNS involvement in 3 (14%), GI in 5 (24%) and marrow in 2 (9.5%). Median KPS was 90% (70-100). Therapy consisted of mBACOD +/- dideoxycytidine (ddC) in 18, misc regimens in others. Median survival for the group is 42.1 mo (24-111). Ten pts remain alive, without evidence of NHL. One pt was lost to f/u after 26+ mo; 10 pts have died, with only 1 death attributable to relapsed NHL. We conclude: (1) Long-term disease free survival is possible in pts with AIDS-lymphoma; (2) Although CD4 less than 200, marrow and CSF involvement, and prior AIDS are considered poor prognostic factors, sustained disease free survival may be achieved in these patients.

Acquired Immunodeficiency Syndrome/COMPLICATIONS Adult CD4 Lymphocyte Count Disease-Free Survival Female Human Lymphoma, AIDS-Related/COMPLICATIONS/*MORTALITY Male Middle Age ABSTRACT

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