HIV-ASSOCIATED NON-HODGKINS-LYMPHOMAS - CLINICAL CHARACTERISTICS AND OUTCOME - THE EXPERIENCE OF THE FRENCH REGISTRY OF HIV-ASSOCIATED TUMORS

From 1/87 to 12/89, the French Registry of HIV-associated tumors recorded 131 cases of intermediate- and high-grade non-Hodgkin's lymphomas (NHL). There were 47 small non-cleaved Burkitt-type lymphomas (SNCL), 32 immunoblastic lymphomas (IL) and 52 diffuse large-cell or predominantly large-cell lymphomas (LCL). There were differences in the clinical patterns of the histological subtypes. Isolated extranodal presentation was less frequent in SNCL (2/47) than in IL (13/32) and LCL (17/49) (p < 0.0001). In the latter two groups, the central nervous system was the principal site of extranodal involvement (16/30). 87% of SNCL patients had no previous manifestations of AIDS whereas 40% of IL and LCL patients presented full-blown AIDS (p < 0.01). At the time of NHL diagnosis, the median blood CD4 lymphocyte count was higher in SNCL (266/mu-L) than in LCL (125/mu-L, p < 0.05) and IL (80/mu-L, p < 0.01). 69% of stages I/II patients, 31% of stages III/IV, and 33% of stage Ie patients achieved complete remission (CR), p < 0.05. Overall median survival time was 5 months. There was no statistical difference in CR and survival rates among histological types. The two-year actuarial survival rate was 25% (median 8 months) for initially asymptomatic patients or those with persistent generalized lymphadenopathy (PGL) and 9% (median 3 months) for those previously with AIDS-related complex (ARC) and AIDS patients (p < 0.001). Response to treatment was the other predictor factor. The two-year survival rate was 42% (median 16 months) for patients who achieved CR, and 5% (median 3 months) for those who did not. Tumor progression was the main cause of death. Prospective treatment trials are urgently needed to define better therapeutic approaches for these patients to improve their prognosis.