Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.
HIV-ASSOCIATED (HIV [+]) LYMPHOMAS: SERUM LDH PREDICTS RESPONSE, BUT SURVIVAL IS POOR DUE TO AIDS (MEETING ABSTRACT)
Proc Annu Meet Am Soc Clin Oncol; 11:A1113 1992. Unique Identifier : AIDSLINE ICDB/92681842 Hagemeister F; Khetan R; Velasquez W; McLaughlin P; Swan F; Romaguera J; Rodriguez M; Cabanillas F; UT M.D. Anderson Cancer Center, Houston, TX 77030
Abstract:
We have evaluated and treated 46 patients (pts) with HIV(+) diffuse lymphomas. These pts had no prior therapy for lymphoma, only 2 had prior opportunistic infections (OI) and 8 had received AZT prior to lymphoma. 46 were homosexual males, and one hemophiliac male. Pathology (Path) included 23 immunoblastic or large cell (LC), 17 small noncleaved (SNC), 3 mixed or small cell (SC) and 3 Hodgkin's disease (HD). 46% of pts with LC or SC had Stage I-II, compared with only 12% of SNC pts. Therapy was intensive chemotherapy based on CHOP or MOPP. Complete response (CR), freedom from progression and survival were evaluated by these variables: stage, Path, OI during therapy, and T4 counts and serum LDH prior to therapy. Pts with normal LDH (less than 225) had 100% CR compared with 66% of those with LDH (greater than or equal to 225), and 93% of Stage I-III had CR compared with only 53% of Stage IV, 81% of LC and 65% of SNC pts. Only 7 of 35 pts had relapse from CR: 3 with SNC, 4 with LC; 5 had a high LDH. OI occurred during therapy in 32 pts and after completion of therapy in 18; 15/17 with T4 less than or equal to 200 had OI compared with 5/10 with T4 greater than 200. The 3 with HD are alive NED; of the remaining 9 living pts, 2 have active lymphoma. Causes of death included lymphoma, 15; OI on therapy, 3; AIDS in first CR from lymphoma, off therapy (KS-2, OI-5, MISC-7); and myelosuppression on therapy, 2. We propose that pts with HIV(+) LCL may have lower stage and LDH than those with HIV(+) SNC, and that LDH can predict which pts will enter and stay in CR. Treatment should be of brief duration and T4 levels may predict the risk of OI. However, measures to control OI and AIDS progression are needed to prevent deaths after achieving CR.
Keywords: Human HIV Infections/COMPLICATIONS Lactate Dehydrogenase/*ANALYSIS Lymphoma, AIDS-Related/*BLOOD/COMPLICATIONS/MORTALITY Lymphoma, Large-Cell/*BLOOD/COMPLICATIONS/MORTALITY Lymphoma, Large-Cell, Immunoblastic/*BLOOD/COMPLICATIONS/ MORTALITY Lymphoma, Small Noncleaved-Cell/*BLOOD/COMPLICATIONS/MORTALITY Opportunistic Infections/COMPLICATIONS ABSTRACT
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Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.
