Non-Hodgkin's lymphoma associated with the acquired immunodeficiency syndrome

Patients with the Acquired Immunodeficiency Syndrome (AIDS) have an increased risk of developing Non-Hodgkin's Lymphomas (NHL). It is estimated that 8-27% of newly diagnosed NHL are associated with AIDS. The majority of these lymphomas are of intermediate or high grade histology. We retrospectively analyzed the clinical manifestations and response to different chemotherapy regimens in patients with AIDS NHL in the San Juan City and San Juan Veterans Administration Hospitals from 1990-1993. Eleven patients (10 M/1F) with an average age of 46 (range 31-68) were analyzed. 64% (7/11) of patients had a prior diagnosis of AIDS before the diagnosis of NHL. Pathology was diffuse large cell in 6, Burkitt's in 4 and immunoblastic in 1.73% of patients presented with Stage III/IV. Sites included gastrointestinal tract (2), skin/soft tissue (2), paranasal sinus (1), kidneys (1). The most common treatment regimen was the modified m-BACOD (64%). Complete response (CR) occurred in 46% (5/11) and partial response (PR) in 27% (3/11). 36% of patients developed opportunistic or bacterial infections during treatment. Median survival was 8 months. Two patients are long-time survivors at 24+, 29+ without evidence of NHL at present. This group of patients demonstrate the usual characteristics of NHL in AIDS patients and corroborate that conventional chemotherapy programs are only moderately effective in these patients. It is clear from this data and from other reports that further work will be required to ascertain optimal therapy for the patient with AIDS-related Non-Hodgkin's Lymphoma.