Anorectal lymphoma and AIDS: An outcome analysis

Background and Objective: Primary lymphoma of the anus is an extremely rare problem. In patients with the Acquired Immune Deficiency Syndrome (AIDS), there is a marked increase in gastrointestinal non-Hodgkin's lymphomas (NHL ). The aim of this study was to evaluate the outcome of patients with anore ctal NHL and AIDS. Methods: Over an 18-year period, we identified 6 patients with AIDS and pri mary anorectal NHL. Five were male. All were high-grade B-cell lymphomas an d half showed systemic "B" symptoms. Patient's mean CD4 count was 93 (range 8 to 201). Results: The average life span for those with "B" symptoms was 6.7 months a nd 16 months for those without symptoms. No benefit was shown from radiatio n or chemotherapy in those with "B" symptoms. Younger patients and those wi thout systemic constitutional symptoms of lymphoma do better. One patient w ithout "B" symptoms was able to tolerate his radiation and chemotherapy and is disease free at 10 months. Conclusion: Despite traditional non-Hodgkin's lymphoma treatment regimens, our AIDS patients (and those examined in a review of the pertinent literatu re) with anorectal NHL and "B" symptoms have a poor prognosis. For those wi thout "B" symptoms and who can tolerate the therapy, NHL remission may be o btained. J. Surg. Oncol. 2000;73:1-5 (C) 2000 Wiley-Liss, Inc.