Background: The development of non-Hodgkin's lymphoma (NHL) in AIDS conveys a poor prognosis with less than 10% of patients surviving beyond two years. These tumours are generally aggressive and often require systemic chemotherapy to bring about effective palliation.
Aims: To report on the long term follow-up of patients with HIV related NHL treated with CEOP chemotherapy.
Methods: This is a retrospective analysis of a group of 18 patients treated at two institutions between October 1990 and 1992 with modified CEOP chemotherapy. Doses were calculated using cyclophosphamide 750 mg/m2, epirubicin 50 mg/m2, vincristine 2 mg and prednisone 75-100 mg x five days, however initial doses of cyclophosphamide and epirubicin were modified to 50-75% of calculated dose.
Results: Seventeen of the 18 patients were male, one female; age range 26-79 (median 36 years); seven with immunoblastic, three Burkitt's, one Ki-1 (anaplastic), six diffuse large cell, and one mixed large and small cell. Eight patients (44%) achieved a complete remission, with seven patients (39%) achieving a partial remission, for an overall response rate of 83% (95% CI = 59-96%). Survival ranged from three-35 months (median nine months). Interestingly, four patients (22%) survived more than two years (median 31 months), three remaining in complete remission at the time of death. Generally therapy was well tolerated and toxicity was manageable.
Conclusions: CEOP is an effective, tolerable and safe regimen and our long term follow-up suggests that there is a small sub-population of patients with HIV and lymphoma who may have a better prognosis and as such would clearly benefit from systemic chemotherapy as a means of prolonging survival and not simply palliation.