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Malignant lymphomas in HIV-seropositive patients. Frequency, features, and prognosis. Report on 31 cases

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Summary

In a random HIV-seropositive population, malignant lymphomas were diagnosed in 31 patients, of whom 24 (77%) had non-Hodgkin lymphoma (NHL) and 7 (23%) Hodgkin lymphoma (HL). The prevalence of NHL among AIDS patients was 8% (23/279 cases), with a prevalence of 17% among autopsied patients (16/96 cases). No patient with HL had AIDS at the time of diagnosis. In 7 of 23 AIDS patients with NHL (30%) the diagnosis was made only post mortem; among these were all 5 patients with primary CNS NHL. Median survival from the time of diagnosis was 1 month for patients with NHL and 3 months for those with HL. In individual patients, survival for several years may be possible with chemotherapy. Certain patients with NHL appear to benefit from intensive chemotherapy with a combination of methotrexate, doxorubicin, cyclophosphamide, vincristine, prednisone, and bleomycin (MACOPB protocol). Appropriate, therapeutic strategies taking into account the patients' individual conditions, including the overall prognosis, urgently requires development. Metastatic CNS involvement, which was the primary cause of death in 5 of 11 patients with NHL (45%) receiving chemotherapy, represents a serious limitation to successful treatment.

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Abbreviations

AIDS:

acquired immunodeficiency syndrome

CB:

centroblastic

CDC:

Centers for Disease Control

CHOP:

cyclophosphamide, doxorubicin, vincristine, prednisone

CMV:

cytomegalovirus

CNS:

central nervous system

COPBLAM:

cyclophosphamide, vincristine, prednisone, bleomycin, doxorubicin, procarbazine

COPP/ABVD:

cyclophosphamide, vincristine, prednisone, procarbazine/doxorubicin, bleomycin, vinblastine, darcarbazine

CR:

complete remission

CT:

computerized tomography

ELISA:

enzyme-linked immunosorbent assay

HIV:

human immunodeficiency virus

HL:

Hodgkin lymphoma

IT:

intrathecal

IMVP16:

ifosfamide, methotrexate, etoposide

KC:

Kiel classification

MACOP-B:

methotrexate, doxorubicin, cyclophosphamide, vincristine, prednisone, bleomycin

ML:

malignant lymphoma

NHL:

non-Hodgkin lymphoma

OI:

opportunistic infection

PCP:

Pneumocystis carinii pneumonia

PD:

progressive disease

PR:

partial remission

RT:

radiation therapy

WBC:

white blood cells

WF:

Working Formulation

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Authors and Affiliations

  1. II. Medizinische Klinik, Universitätsklinikum Rudolf Virchow, Deutschland

    D. Schürmann, H. D. Pohle & B. Ruf

  2. Institut für Pathologie, Universitätsklinikum Steglitz, Deutschland

    D. Dienemann & H. Stein

  3. Institut für Pathologie, Universitätsklinikum Rudolf Virchow, Deutschland

    G. Jautzke

  4. Institut für Neuropathologie, Universitätsklinikum Steglitz, Deutschland

    J. Cervos-Navarro

  5. Abteilung für Oralchirurgie der Zahnklinik Nord, Freie Universität Berlin, Deutschland

    A. Langford

Authors
  1. D. Schürmann
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  2. D. Dienemann
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  3. G. Jautzke
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  4. J. Cervos-Navarro
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  5. A. Langford
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  6. H. Stein
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  7. H. D. Pohle
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  8. B. Ruf
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Schürmann, D., Dienemann, D., Jautzke, G. et al. Malignant lymphomas in HIV-seropositive patients. Frequency, features, and prognosis. Report on 31 cases. Klin Wochenschr 69, 679–686 (1991). https://doi.org/10.1007/BF01649436

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  • DOI: https://doi.org/10.1007/BF01649436

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