HIV-associated lymphoma of the gastrointestinal tract (Meeting abstract).

Important note: Information in this article was accurate in 1993. The state of the art may have changed since the publication date.

HIV-associated lymphoma of the gastrointestinal tract (Meeting abstract).

Proc Annu Meet Am Soc Clin Oncol; 12:A1 1993. Unique Identifier : AIDSLINE ICDB/93694401
Imrie K; Sawka C; Kutas G; Burkes R; Warner E; Brandwein J; Shepherd F; Univ. of Toronto, Toronto, Canada

Abstract: Non-Hodgkin's lymphoma occurring in HIV-infected patients (pts) has a predilection for extranodal sites. We report a series of 24 pts (23 male, 1 female) with HIV-associated GI lymphoma. Their median age was 38 yr (range 24-59). HIV infection antedated the development of lymphoma by 0-108 mo and lymphoma was the AIDS defining diagnosis in 67%. The GI tract was the only site of involvement in 21% (Stage IE, 4; IIE, 1), and B symptoms were present in 92% at diagnosis. Sites of involvement included stomach (38%), small bowel (33%), appendix (4%), colon (25%), and rectum (13%). Pathology was diffuse large cell in 33%, immunoblastic in 33%, small cell, noncleaved in 25%, and other in 8%. Mean CD4 count at diagnosis was 120 (range 4-1120). Treatment included surgery (29%), chemotherapy (86%), radiotherapy only (4%), and supportive care only (8%). Seven (33%) pts achieved CR with chemotherapy and 9 (43%) PR. Perforation occurred in 4 pts; 2 at diagnosis, 1 on therapy and 1 at relapse. One pt had GI bleeding at diagnosis, and 1 at relapse. Median survival was 6 mo (range less than 1-24+) from diagnosis. Death was due to lymphoma in 57%, treatment toxicity in 10%, and other AIDS-related illnesses in 33%. Survival was unrelated to histology, duration of HIV infection, prior AIDS diagnosis, CD4 count, or surgery. In summary, HIV-associated GI lymphoma is responsive to chemotherapy, but treatment-related toxicity is high, and overall survival is short. Perforation appears more common than in HIV-negative pts with GI lymphoma, but is frequently not therapy-related.

Keywords: Adult Cause of Death Combined Modality Therapy CD4-Positive T-Lymphocytes/*IMMUNOLOGY Female Follow-Up Studies Gastrointestinal Neoplasms/*DIAGNOSIS/MORTALITY/THERAPY Human Leukocyte Count Lymphoma, AIDS-Related/*DIAGNOSIS/MORTALITY/THERAPY Male Middle Age Survival Rate ABSTRACT
931230
M93C0825

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