Stage, serum LDH, and performance status predict disease progression and survival in HIV-associated lymphomas

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Abstract
Purpose : This is a review of treatment of 44 patients with positive HTV serology (positive HIV) and lymphoma. Materials and methods :Twenty patients had diffuse large-cell lymphoma (DLCL), and 18 had small noncleaved-cell lymphoma (SNCCL). Three had Hodgkin's disease (HD) and 3 had diffuse small- or mixed-cell lymphoma. These patients received intensive 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 (CR) was 77% for all patients, 80% for those with DLCL, and 72% for those 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 T 4 -cell count of ⩽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 after completion of therapy in complete remission, with a median survival of only 11 months, and were attributable to AIDS-related complications. Conclusions : Our data suggest that (1) patients with lym-phoma who have positive HIV have responses to chemotherapy similar to those expected for patients who are HTV-nega-tive; (2) most infectious complications are manageable with appropriate therapy during treatment; and (3) after completion of chemotherapy, treatment should focus on control of progression of AIDS-related complications.