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Malignant gastrointestinal lymphomas in patients with AIDS
W Heise1, K Arastéh, P Mostertz
1Department of Gastroenterology and Infectious Diseases, Anguste Viktoria Hospital, Berlin, Germany.
Digestion
|January 1, 1997
Summary
Gastrointestinal lymphoma is common in advanced HIV infection, often presenting with unusual symptoms. Prognosis for AIDS patients with GI lymphoma depends on prior AIDS-defining illnesses, not CD4 count or lymphoma type.
Area of Science:
- Oncology
- Gastroenterology
- Infectious Diseases
Background:
- HIV-associated malignant lymphomas frequently involve the gastrointestinal tract in advanced HIV infection.
- Non-Hodgkin's lymphoma occurred in 3.9% of HIV-positive patients, with 44.4% showing gastrointestinal involvement.
Purpose of the Study:
- To investigate the prevalence, diagnostic methods, clinical presentation, and prognostic factors of gastrointestinal lymphoma in HIV-infected patients.
Main Methods:
- Retrospective analysis of 108 HIV-positive patients with non-Hodgkin's lymphoma, focusing on gastrointestinal manifestations.
- Diagnostic procedures included endoscopy, laparotomy, and laparoscopy.
Main Results:
- Gastrointestinal lymphoma was diagnosed in 44.4% of HIV-associated lymphomas, with endoscopy being a reliable diagnostic tool.
- Unusual presentations (oral, esophageal, perianal) and life-threatening complications (bleeding, perforation) were common.
- High-grade B-cell lymphomas were prevalent, with 52% in advanced stages (Ann Arbor III/IV). Standard chemotherapy yielded a mean survival of 4.8 months.
Conclusions:
- Prognosis in AIDS patients with gastrointestinal lymphoma is primarily determined by the presence of prior AIDS-defining diseases.
- CD4 cell count, specific lymphoma subtypes, or gastrointestinal complications did not significantly impact survival.