NON-HODGKINS-LYMPHOMA ASSOCIATED TO THE A CQUIRED-IMMUNODEFICIENCY-SYNDROME - MULTICENTER CLINICAL-STUDY OF 77 CASES

BACKGROUND: The aim of the present was to study the prevalence of non Hodgkin's lymphoma (NHL) in AIDS patients as well as the clinicopathol ogic characteristics, response to treatment and survival. METHODS: Fro m January 1984 to January 1991, 77 patients with NHL associated with A IDS diagnosed in 9 hospitals in Madrid were retrospectively studied. R ESULTS: Ninety-two per cent of the patients were men (mean age 30 year s: range: 9.66 years), 62% were intravenous drug abusers and 20 (26%) homosexuals. Pathologic study determined that 62 (80%) patients had hi gh grade NHL (44% small noncleaved), 17% immunoblastic and 20% unclass ifiable, and 15 (20%) had intermediate grade (16% diffuse large cell) being all the cases of the B immunophenotype, Sixty five per cent were in advanced stages and 69% had B symptoms. Extranodal localizations w ere present in 88%, bone marrow in 29% and CMS in 29%. Six cases had p rimary CNS lymphomas 50% of the patients had less than 200 x 10(6)/l C D4 lymphocytes. Forty-seven patients were evaluable for response to ch emotherapy: 12 (26%) showed a complete response 27 (57%) a partial res ponse and 8 (17%) did not respond, Opportunistic infections developed in 18%. The estimated survival at 3 years was 14% (median 6 months), O n univariate analysis the parameters related to the worst survival wer e: primary CNS lymphoma, liver involvement lack of treatment response, LDH greater than or equal to 300 Ul/l, alkaline phosphatase greater t han or equal to 500 Ul/l and ESR greater than or equal to 70 mm. CONCL USIONS: Non Hodgkin's lymphomas associated with AIDS usually behave in an <<aggressive>> way with a high frequency of advanced stages, B sym ptoms, high grade histologic subtypes and extranodal involvement Respo nse to treatment is poor, hone marrow toxicity frequent and survival s hort.