STAGE, SERUM LDH, AND PERFORMANCE STATUS PREDICT DISEASE PROGRESSION AND SURVIVAL IN HIV-ASSOCIATED LYMPHOMAS

Purpose: This is a review of treatment of 44 patients with positive HI V serology (positive HIV) and lymphoma. Materials and methods: Twenty patients had diffuse large-cell lymphoma (DLCL), and 18 had small nonc leaved-cell lymphoma (SNCCL). Three had Hodgkin's disease (HD) and 3 h ad diffuse small- or mixed-cell lymphoma. These patients received inte nsive 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 (C R) was 77% for all patients, 80% for those with DLCL, and 72% for thos e 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 less-than-or-equal-to 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 a fter completion of therapy in complete remission, with a median surviv al of only 11 months, and were attributable to AIDS-related complicati ons. Conclusions: Our data suggest that (1) patients with lymphoma who have positive HIV have responses to chemotherapy similar to those exp ected for patients who are HIV-negative; (2) most infectious complicat ions are manageable with appropriate therapy during treatment; and (3) after completion of chemotherapy, treatment should focus on control o f progression of AIDS-related complications.