Natural history, treatment outcome and causes of death in AIDS-related primary central nervous system lymphoma (PCNSL) (Meeting abstract).

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Natural history, treatment outcome and causes of death in AIDS-related primary central nervous system lymphoma (PCNSL) (Meeting abstract).

Proc Annu Meet Am Soc Clin Oncol; 13:A18 1994. Unique Identifier : AIDSLINE ICDB/94600015
Lee J; Kaplan LD; Conant M; Northfelt DW; Univ. of California, San Francisco 94143-1270

Abstract: Objectives: To better define the natural history of PCNSL, evaluate the efficacy of standard radiotherapy (RadRx), and determine the causes of death in affected patients (pts). Methods: 56 HIV-infected pts with pathologically documented PCNSL were identified in the UCSF Tumor Registry from January 1988 to December 1991. Medical records were reviewed to obtain: HIV-related medical history, CD4 count at PCNSL diagnosis, method of diagnosis, type of therapy given, clinical and radiographic response to therapy, survival duration, causes of death. Results: Natural History: median CD4 count at diagnosis: 20 cells/mm3 (n=40, range 1-492) median number prior opportunistic infections (OI): 2 (n=53, range 0-5) diagnosis: biopsy: 53 (95%); autopsy: 2 (3%); lumbar puncture: 1 (2%) number with PCNSL as primary AIDS diagnosis: 8 of 56, number receiving prior antiretroviral therapy: 42 of 56 (75%); number receiving P carinii prophylaxis: 45 of 56 (80%). Response to RadRx: (n=29); clinical response only: 9 (31%); radiographic response only: 5 (17%); clinical and radiographic response: 9 (31%); no response: 6 (21%). Median survival (in months): (n=38). All pts: 3 (1-22); RadRx (n=27): 4 (2-16); No therapy (n=9): 1 (1-7). Causes of Death: (n=38) death due to: PCNSL: 24 (63%); OI: 8 (21%); unknown: 6 (16%). Conclusions: As in other reported series, the majority of our pts developed PCNSL in the setting of advanced HIV disease characterized by low CD4 count, numerous prior OIs, and previously established AIDS diagnosis. Most pts (79%) who received RadRx for PCNSL obtained clinical or radiographic response, or both. Survival was longer among pts who were treated although cause and effect cannot be established in this retrospective analysis. PCNSL was the most commonly documented cause of death in this cohort, suggesting that more effective treatment modalities are needed.

Keywords: Acquired Immunodeficiency Syndrome/*MORTALITY/*RADIOTHERAPY Adult Brain Neoplasms/*MORTALITY/RADIOTHERAPY *Cause of Death Cranial Irradiation Female Follow-Up Studies Human Lymphoma, AIDS-Related/*MORTALITY/RADIOTHERAPY Male Middle Age Survival Rate Treatment Outcome ABSTRACT
940830
M9480785

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