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Chemotherapy combined with highly active antiretroviral therapy for the treatment of aggressive AIDS related lymphomas

Non-Hodgkin lymphoma is one of the most frequent oncological complications in patients with the Acquired Immune-Deficiency Syndrome (AIDS). In other countries, after the introduction of the Highly Active Antiretroviral Therapy (HAART), the drop in the incidence of systemic aggressive lymphomas was below expectations, although the survival of these patients rose. In Brazil, little is known about the clinical behavior and survival of the patients with lymphoma and AIDS in the post-HAART era. The aim of this study was to retrospectively evaluate 25 patients with lymphomas and AIDS, treated with the combination of chemotherapy and HAART. In agreement with the literature most of the patients were male (20 patients - 80%) with a median age of 39 years. We observed a predominance of the Diffuse Large B Cell Lymphoma subtype (13 patients - 52%), advanced stage (15 patients - 60%), with extra-nodal disease (22 patients - 88%) and B symptoms (18 patients - 72%). Previous AIDS diagnosis was present in 14 patients (56%), higher than that reported in other series. Fifty-two percent achieved CR, the estimated probability of overall survival and disease-free survival at 3 years were 54% e 42%, respectively. The median overall survival time was 15 months. Hematological toxicity and infections were frequently observed, but no toxicity-related deaths were seen. Therefore we conclude that the combined chemotherapy-HAART treatment is feasible in Brazilian patients and can provide similar overall survival than that described for some international groups, with an acceptable toxicity profile.

Lymphoma; AIDS; Highly active antiretroviral therapy; chemotherapy


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