Chemotherapy in patients with acquired immunodeficiency virus syndrome associated with non-Hodgkin's lymphoma

We retrospectively analyzed our chemotherapy results in patients with the Acquired Immunodeficiency Virus syndrome (AIDS) and lymphoma over a 10 year period. Thirty out of 492 (6%) Human Immunodeficiency Virus (HIV) positive patients developed a non-Hodgkin's lymphoma. Thirteen patients with high-grade histology were treated with chemotherapy, 6 patients received CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone) and 7 patients received CEOP/IMVP-Dexa (cyclophosphamide, epirubicin, vincristine, prednisolone, ifosfamide, methotrexate, VP-16, and dexamethasone). The overall response rate was 77%, with no difference between the CHOP and CEOP/IMVP-Dexa regimens. There was no difference between the two treatment groups with respect to median overall survival (9 months for CHOP and 11.4 months for CEOP/IMVP-Dexa) or median lymphoma free survival (10.7 months for CHOP and not reached for CEOP/IMVP-Dexa). All patients treated with CEOP/IMVP-Dexa had WHO grade 3 or 4 infections, while only 2 of 6 patients treated with CHOP had WHO grade infections, and no grade 4 infection occurred (P < 0.01). Intensive regimens such as CEOP/IMVP-Dexa seem to be too toxic for patients with HIV-associated non-Hodgkin's lymphoma.