Document 2999
 DOCN  M94A2999
 TI    Are some HIV-related non-Hodgkin's lymphomas curable malignancies?
 DT    9412
 AU    Vaccher E; Tirelli U; Errante D; Serraino D; Tavio M; Spina M; Bernardi
       D; Nasti G; Carbone A; Division of Medical Oncology and AIDS, C.R.O.,
       Aviano, Italy.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):177 (abstract no. PB0136). Unique
       Identifier : AIDSLINE ICA10/94369576
 AB    OBJECTIVE: The overall outcome of patients with HIV-related
       non-Hodgkin's lymphomas (HIV-NHL) is poor because of the adverse
       clinico-pathological features and of the underlying HIV infection.
       However, the increased experience of physicians using intensive
       chemotherapy, has led to an improvement in the prognosis of systemic
       HIV-related NHL. Today some patients with AIDS may be expected to
       survive for at least 4-5 years, so that it is possible to evaluate the
       potential long-term efficacy of the treatment of patients with
       aggressive NHL, such as Burkitt's lymphoma, that usually may be
       considered curable after two years of lasting complete remission (CR)
       after chemotherapy. To evaluate this possibility, we reviewed our
       monoinstitutional experience at the Aviano Cancer Institute, Italy, with
       emphasis on the clinico-pathological characteristics of a subgroup of 13
       patients with long-term survival, observed between April 1985 and
       February 1993. METHODS: We have arbitrarily identified two groups of
       patients, the first one (group A) including patients with a CR lasting
       for at least two years and the other comprising all remaining patients
       (group B). RESULTS: Comparing the two groups we found that the 13
       patients of group A differed significantly from the other patients in
       terms of better CD4+ cell count and performance status (PS) at the time
       of diagnosis of NHL, while there was no significant difference in the
       histological subtypes. The overall survival of the 73 patients was 8
       months. Four prognostic factors influenced survival: younger patients,
       those who had a better PS, those with CD4+ cell count > or = 100/mm3 and
       patients without B symptoms had a significantly longer survival period.
       The median survival in patients of group A was 42 months (range 24-72),
       but none of these patients relapsed after up to 6 years of observation.
       DISCUSSION AND CONCLUSIONS: A subgroup of patients can be cured from
       HIV-related NHL, with some being alive without evidence of disease 3 to
       6 years after therapy, and others who died of causes related to
       underlying HIV infection, in particular opportunistic infections, but
       without relapse of NHL.
 DE    Acquired Immunodeficiency Syndrome/*DRUG THERAPY/MORTALITY
       Antineoplastic Agents, Combined/*THERAPEUTIC USE  Cause of Death
       Follow-Up Studies  Human  Italy  Lymphoma, AIDS-Related/*DRUG
       THERAPY/MORTALITY  Remission Induction  Support, Non-U.S. Gov't
       Survival Rate  MEETING ABSTRACT

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