[Non-Hodgkin's malignant lymphoma and human immunodeficiency virus. Apropos of 34 cases]

The characteristics of 34 HIV-associated non Hodgkin's lymphomas diagnosed and treated at Bordeaux hospitals are described. The patients represented 7% of the AIDS cases observed in the Bordeaux area. HIV-lymphomas were almost always high-grade malignancies, usually disseminated (70%) with extranodal disease at presentation (91%) primarily in the bone marrow, meninges, gastrointestinal tract and liver. Twenty-eight patients were treated with different chemotherapy protocols or radiation therapy alone. Complete remission was achieved in 11 patients and partial remission in 3. The median survival was 3.9 months. Despite utilization of low-intensity chemotherapy regimens, opportunistic infections were not prevented. The only factor that accurately predicted complete remission was the WHO performance index. The total number of CD4-positive lymphocytes, the Ann Arbor stage and the WHO performance index were prognostic factors influencing survival. These results justify the use of high-intensity regimens, but only for patients without opportunistic infection and with a WHO performance index below 3.