Original Article
Low-Dose Compared with Standard-Dose m-BACOD Chemotherapy for Non-Hodgkin's Lymphoma Associated with Human Immunodeficiency Virus Infection
N Engl J Med 1997; 336:1641-1648June 5, 1997
- Abstract
Background
Reduced doses of cytotoxic chemotherapy or standard-dose therapy plus a myeloid colony-stimulating factor decreases hematologic toxicity and its complications in patients with non-Hodgkin's lymphoma associated with infection with the human immunodeficiency virus (HIV). However, the effect of reducing the doses of cytotoxic chemotherapeutic agents on clinical outcome is not known.
Methods
We randomly assigned 198 HIV-seropositive patients with previously untreated, aggressive non-Hodgkin's lymphoma to receive standard-dose therapy with methotrexate, bleomycin, doxorubicin, cyclophosphamide, vincristine, and dexamethasone (m-BACOD) along with granulocyte–macrophage colony-stimulating factor (GM-CSF; n = 94) or reduced-dose m-BACOD with GM-CSF administered only as indicated (n = 98).
Results
A complete response was achieved in 39 of the 94 assessable patients assigned to low-dose therapy (41 percent) and in 42 of the 81 assessable patients assigned to standard-dose therapy (52 percent, P = 0.56). There were no significant differences in overall or disease-free survival; median survival times were 35 weeks for patients receiving low-dose therapy and 31 weeks for those receiving standard-dose therapy (risk ratio for death in the standard-dose group, 1.17; 95 percent confidence interval, 0.84 to 1.63; P =0.25). Toxic effects of chemotherapy rated grade 3 or higher occurred in 66 of 94 patients assigned to standard-dose therapy (70 percent) and 50 of 98 patients assigned to low-dose treatment (51 percent, P = 0.008). Hematologic toxicity accounted for the difference.
Conclusions
As compared with treatment with standard doses of cytotoxic chemotherapy (m-BACOD), reduced doses caused significantly fewer hematologic toxic effects yet had similar efficacy in patients with HIV-related lymphoma. Dose-modified chemotherapy should be considered for most HIV-infected patients with lymphoma.
Media in This Article
Figure 2
Overall Survival among Patients with CD4+ Cell Counts below and Those with CD4+ Counts at or above 100 per Cubic Millimeter Who Were Treated with Low-Dose or Standard-Dose m-BACOD Therapy.Figure 1
Overall Survival (Panel A) and Disease-free Survival (Panel B) among Patients Treated with Low-Dose m-BACOD Therapy or Standard-Dose m-BACOD Therapy.Article Activity
- Article
The human immunodeficiency virus (HIV) increases the risk of aggressive B-cell lymphoma,1,2 which often presents at an advanced stage and frequently involves extranodal sites, such as the central nervous system and bone marrow.3-7 In HIV-infected patients, the rate of complete response to the treatment of lymphoma with combination chemotherapy is approximately 50 percent, and the median survival is only five to six months.4-6,8 Factors that favor longer survival include a higher number of CD4+ lymphocytes,4,9 the absence of a prior diagnosis indicating progression to the acquired immunodeficiency syndrome (AIDS),4,9 a Karnofsky performance score of 70 or more,4,9 the absence of extranodal disease,4 an early disease stage (I or II),10,11 a nonimmunoblastic subtype,5,10 polyclonality,12 the absence of bone marrow involvement,9 an age of less than 35 years,11 and a low serum lactate dehydrogenase concentration.11
Treatment of HIV-related lymphoma with myelotoxic drugs frequently causes prolonged neutropenia. The poor bone marrow reserve in patients with HIV-related lymphoma makes the administration of standard doses of chemotherapy difficult. Previous clinical trials have demonstrated that hematologic toxic effects and their sequelae can be lessened by reducing the dose of chemotherapy13 or using colony-stimulating factor as support during standard-dose therapy.8,14 However, the effect of a reduction in the dose of chemotherapeutic agents on outcome is not known. In this trial, we evaluated the response rates, survival, and toxic effects in HIV-infected patients with non-Hodgkin's lymphoma who were treated with reduced-dose chemotherapy or a standard-dose therapy with granulocyte–macrophage colony-stimulating factor (GM-CSF) as support.
Methods
Eligibility and Pretreatment Evaluation
HIV-seropositive patients over 12 years of age were eligible if they had previously untreated intermediate- or high-grade lymphoma, confirmed by biopsy or cytologic study, at any stage and had no acute opportunistic infection. Determination of disease stage included chest radiography; computed tomographic or magnetic resonance scanning of the chest, abdomen, pelvis, and brain; bilateral iliac-crest bone marrow biopsy; and lumbar puncture with routine studies and cytologic examination.
Treatment
After stratification according to the presence or absence of a prior AIDS-defining diagnosis and according to the Karnofsky performance score (>70 or <70), patients were randomly assigned to receive standard-dose chemotherapy with methotrexate, bleomycin, doxorubicin, cyclophosphamide, vincristine, and dexamethasone (m-BACOD) with GM-CSF support, beginning with the first cycle of chemotherapy, or reduced-dose m-BACOD chemotherapy without routine GM-CSF (Table 1Table 1
Low-Dose and Standard-Dose m-BACOD Chemotherapy Regimens.).GM-CSF (molgramostim, Leucomax, Schering-Plough, Kenilworth, N.J.), in a dose of 5 μg per kilogram of body weight per day, was administered subcutaneously on days 4 through 13 of each chemotherapy cycle to all patients randomly assigned to standard-dose chemotherapy. The duration of GM-CSF administration was extended beyond day 13 during episodes of febrile neutropenia. Administration of GM-CSF to patients in the low-dose group was not allowed until September 1991, when the administration of GM-CSF during subsequent cycles of low-dose chemotherapy was allowed if the absolute neutrophil count was below 1000 per cubic millimeter on day 22 of any chemotherapy cycle or below 500 per cubic millimeter at any time during a chemotherapy cycle.
Antiretroviral therapy was optional, but zidovudine was specifically excluded because of its potential for myelosuppression.
In both groups, cycles of chemotherapy were initiated after the neutrophil count recovered to at least 1000 per cubic millimeter, but not earlier than day 22 of the previous cycle. Chemotherapy was administered for two cycles after a complete remission was achieved and for a minimum of four cycles.
Meningeal lymphoma was treated with whole-brain radiotherapy at a rate of 200 cGy per day, for a total dose of 2400 cGy. Cytarabine (50 mg) was administered intrathecally three times per week until the cerebrospinal fluid was cleared of malignant cells, and then monthly for one year.
Clinical and laboratory assessments were performed at the start of each treatment cycle, and a complete blood count was obtained weekly. Complete restaging was performed for all previously identified sites of disease after every other cycle and at the conclusion of chemotherapy.
Assessment of Quality of Life and Central Pathological Review
Patients completed a quality-of-life questionnaire at base line, after cycles 1 and 3, and four weeks after the completion of chemotherapy. The questionnaire was based on an earlier version of the General Health Assessment Questionnaire currently used in several AIDS Clinical Trials Group (ACTG) trials.15
Histologic and cytologic diagnoses were reviewed retrospectively by a single pathologist.
End Points
The primary end point was survival from the time of initiation of chemotherapy. Secondary end points included the rate of complete response, the duration of antitumor response, the development of opportunistic infection, and toxic effects of treatment. The longest tumor dimension and the length of the perpendicular dimension were measured. Antitumor responses were graded according to standard oncologic criteria. A complete response was defined as the absence of clinically detectable disease and normal radiographic studies at any previously abnormal sites for at least four weeks. A partial response was defined as a decrease of at least 50 percent in the measurable tumor burden lasting for at least one month. Stable disease was defined as a reduction of less than 50 percent in measurable disease in the absence of progression. Progressive disease was defined as a 25 percent or greater increase in measurable disease, or the appearance of disease at a new site. The length of time to disease progression was measured from the initiation of chemotherapy until progression was documented. The standard criteria of the World Health Organization were used to grade toxic effects.
The relative dose intensity (the ratio of the actual dose to the expected dose per unit of time) was calculated for each agent as 100×D ÷ T, where D = the sum of doses received in each cycle ÷ (the initial dose prescribed × the number of cycles administered) and T = drug-exposure time ÷ (21 days × the number of cycles received).
Statistical Analysis
We used an intention-to-treat approach that included all observations even when therapy was discontinued prematurely. Differences in survival between the treatment groups were evaluated with the Wilcoxon log-rank test and Cox regression analysis. The sample size gave the study 80 percent power to detect an increase in survival from six to nine months. Quality-of-life data were analyzed by analysis of variance, in which scores after randomization were compared, with adjustment for base-line levels.
Results
Characteristics of Patients
Between February 1991 and October 1994, we randomly assigned 198 patients at 27 ACTG sites to treatment groups. Six of these patients were never actually treated — one who was discovered not to have lymphoma, one who had an acute opportunistic infection, one who was lost to follow-up after randomization, and three because of violations of the entry criteria. After these 6 patients were excluded, the sample consisted of 98 patients assigned to low-dose treatment and 94 assigned to standard-dose therapy.
Forty patients (20 percent of the total enrollment) underwent randomization before the protocol was modified to allow GM-CSF to be administered to patients receiving low-dose therapy if they had neutropenia. Of these 40 patients, 1 never received the study treatment, 19 were assigned to receive low-dose treatment, and 20 were assigned to receive standard-dose therapy.
The two groups did not differ significantly with respect to established predictive factors, including the Karnofsky performance score; the CD4+ lymphocyte count; the presence or absence of a previous AIDS-defining opportunistic illness, extranodal involvement, or bone marrow involvement; the lactate dehydrogenase concentration; the disease stage; and age (Table 2Table 2
Pretreatment Characteristics of Patients Assigned to Low-Dose and Standard-Dose m-BACOD.). The most common extranodal sites of disease were the liver (in 26 percent of the patients), the gastrointestinal tract (24 percent), the bone marrow (15 percent), and the lung (14 percent). Only three patients in each treatment group had lymphomatous meningitis at entry.Patients assigned to low-dose therapy received a mean (±SE) of 3.8±1.8 cycles of chemotherapy, whereas those assigned to standard-dose therapy received a mean of 3.2±1.7 cycles. Patients in each treatment group received therapy at 90 to 100 percent of the planned dose intensity for each cytotoxic agent, except for methotrexate. For that drug the relative dose intensity was significantly lower for patients assigned to standard-dose therapy (74 percent) than for those assigned to low-dose therapy (84 percent, P = 0.005). Of the patients assigned to low-dose therapy after the protocol was modified to allow GM-CSF prophylaxis in this group, 36 of 79 (46 percent) received GM-CSF at some time during therapy.
Therapeutic Response
The mean lengths of follow-up in the low-dose group (10.6±1.05 months) and the standard-dose group (9.1±0.94 months) did not differ significantly. Data on responses to chemotherapy were available for 175 patients (91 percent) — 94 assigned to low-dose therapy and 81 assigned to standard-dose therapy (Table 3Table 3
Rates of Response to Low-Dose and Standard-Dose m-BACOD Therapy.). There were no significant differences in response rates between the two treatment groups (Table 3). The median length of time to complete remission was eight weeks for both groups.Nine patients in the low-dose group had recurrence of disease after a complete response (23 percent), as did 17 (40 percent) in the standard-dose group (P = 0.08). The median time to recurrence after a complete response was 106 weeks in the standard-dose group and had not been reached at 190 weeks in the low-dose group (P = 0.06). The overall length of time to disease progression was similar in the two groups — a median of 39 weeks for the low-dose group and 30 weeks for the standard-dose group. Meningeal relapse occurred in three patients in each treatment group.
No significant differences were noted in overall or disease-free survival (Figure 1AFigure 1
Overall Survival (Panel A) and Disease-free Survival (Panel B) among Patients Treated with Low-Dose m-BACOD Therapy or Standard-Dose m-BACOD Therapy. and Figure 1B). The median survival time was 35 weeks (95 percent confidence interval, 30 to 45) for patients receiving low-dose therapy and 31 weeks (95 percent confidence interval, 22 to 42) for those receiving standard-dose therapy. The risk ratio for death was 1.17 in the standard-dose group as compared with the low-dose group (95 percent confidence interval, 0.84 to 1.63; P = 0.25). The median length of disease-free survival was 56 weeks in the low-dose group and 38 weeks in the standard-dose group (risk ratio for death or recurrent disease in the standard-dose group, 1.22; 95 percent confidence interval, 0.71 to 2.09; P = 0.28). Twenty-six patients receiving low-dose therapy (27 percent) and 23 receiving standard-dose therapy (24 percent) survived for more than one year. Eleven patients receiving low-dose therapy (11 percent) and seven receiving standard-dose therapy (7 percent) survived for more than two years.Patients with CD4+ lymphocyte counts above 100 per cubic millimeter survived longer, on average, than those with counts of 100 or fewer, but there were no significant differences in survival between the treatment groups after we controlled for the absolute CD4+ count (P = 0.23) (Figure 2Figure 2
Overall Survival among Patients with CD4+ Cell Counts below and Those with CD4+ Counts at or above 100 per Cubic Millimeter Who Were Treated with Low-Dose or Standard-Dose m-BACOD Therapy.). Among patients with CD4+ lymphocyte counts above 200 per cubic millimeter, the median survival times were 66 weeks for the low-dose group and 73 weeks for the standard-dose group (P = 0.89).There was no significant difference in survival between the two groups in a multivariate analysis in which we controlled for disease stage (I or II vs. III or IV), the presence or absence of extranodal involvement, the presence or absence of bone marrow involvement, the histologic type of tumor (large cell vs. small noncleaved cell), the lactate dehydrogenase concentration, the Karnofsky performance score (<70 vs. >70), risk group, and age.
Causes of Death
The three treatment-associated deaths were due to respiratory failure caused by ascending paralysis resulting from cytarabine toxicity, hepatic failure, and sepsis with neutropenia. Of the 140 patients who died during follow-up, the cause of death was lymphoma, progression of HIV, or a combination of both in 128 (91 percent). Forty-nine (70 percent) of the patients in the low-dose group who died and 40 (57 percent) of the patients in the standard-dose group who died had active lymphoma at the time of death (P = 0.50). Among the patients who died, progression of HIV alone was the primary cause of death for 18 patients receiving low-dose therapy (26 percent) and 21 receiving standard-dose therapy (30 percent).
Toxic Effects
Grade 3 or higher-grade toxic effects of chemotherapy occurred in 66 patients assigned to standard-dose therapy (70 percent) and 50 patients assigned to low-dose therapy (51 percent) (P = 0.008). Grade 4 neutropenia (absolute neutrophil count, <500 per cubic millimeter) developed in 49 patients who received low-dose therapy (50 percent), as compared with 65 assigned to standard-dose therapy (69 percent) (P = 0.007). Similarly, 89 of 373 chemotherapy cycles in the low-dose group (24 percent) and 117 of 299 cycles in the standard-dose group (39 percent) were associated with grade 4 neutropenia. Episodes of febrile neutropenia complicated 6 percent of the cycles (22 of 373) in patients assigned to low-dose therapy and 8 percent of the cycles (24 of 299) in the standard-dose group. Grade 3 or higher-grade thrombocytopenia was observed in 11 of the patients assigned to low-dose therapy (11 percent) and 32 of those assigned to standard-dose treatment (34 percent) (P<0.001). Grade 3 or higher-grade anemia occurred in 31 of the patients given low-dose therapy (32 percent) and 49 of those assigned to standard-dose therapy (52 percent) (P<0.001).
The only significant differences in nonhematologic toxic effects between the treatment groups were that shortness of breath was more common in the standard-dose group and elevations in aspartate aminotransferase concentrations were more common in the low-dose group (Table 4Table 4
Adverse Events during Treatment with Low-Dose or Standard-Dose m-BACOD.).Opportunistic Illness
An AIDS-defining opportunistic illness complicated treatment in 22 of the patients receiving low-dose chemotherapy (22 percent) and 22 of those receiving standard-dose chemotherapy (23 percent) (P = 1.0).
Central Pathological Review
Among the 192 patients in the study, histologic or cytologic specimens were submitted for review for 137 (71 percent). This audit confirmed the diagnosis of non-Hodgkin's lymphoma in all but one case. On the basis of these specimens, 85 patients (62 percent) were classified as having large-cell lymphoma (intermediate-grade, diffuse large-cell, and high-grade immunoblastic types), 35 (26 percent) were classified as having small-noncleaved-cell lymphomas, and 17 (12 percent) were classified as having high-grade lymphomas, not otherwise specified. The median survival times were 36±3.5 weeks for the patients with large-cell lymphomas, 41±12.8 weeks for those with small-noncleaved-cell lymphomas, and 29.6±9.4 weeks for those with nonspecific high-grade lymphomas. These times are not significantly different. Among 84 specimens reviewed by both the central study pathologist and an outside pathologist, there was disagreement regarding the histologic subtype in 29 percent of the cases.
Quality of Life
The number of hospital days for patients in the standard-dose group was 76 percent higher than that for the low-dose group (P = 0.03). The scores on 11 of the remaining 12 quality-of-life measures indicated a worse quality of life for the group given standard-dose therapy, although not significantly so.
Discussion
We did not find that standard-dose m-BACOD chemotherapy was superior to low-dose chemotherapy in patients with HIV-related lymphoma. However, we did find that patients treated with low-dose m-BACOD had significantly fewer hematologic toxic effects and spent fewer days in the hospital than patients treated with conventional doses of m-BACOD. These findings were independent of the absolute CD4+ lymphocyte count, although the number of participants with counts above 200 per cubic millimeter was too low for us to determine whether some of them might have benefited from more aggressive therapy. Nevertheless, the data justify the treatment of most patients who have HIV-associated lymphoma with reduced doses of cytotoxic chemotherapy.
Previous clinical trials have demonstrated that the use of a myeloid colony-stimulating factor8,14 or a low-dose regimen of m-BACOD reduces hematologic toxicity.13 More aggressive regimens, on the other hand, have generally been associated with a poor clinical outcome and a high incidence of fatal opportunistic infection.4,16 The relatively favorable outcome with the aggressive LNH84 chemotherapy regimen may have been related to the median CD4+ count of more than 200 per cubic millimeter in the study population.10
Our results indicate that the absolute CD4+ cell count is a more important predictor of survival than the dose intensity of chemotherapy. When patients were grouped according to the CD4+ count, longer survival was linked to higher CD4+ counts but not to the type of treatment (Figure 2). Although this analysis is limited by the small number of patients with CD4+ T-cell counts above 200 per cubic millimeter, the survival curves for the two treatment groups appear similar even for patients with more than 200 CD4+ lymphocytes per cubic millimeter, suggesting that our results might apply to patients with relatively intact immune function.
Severe neutropenia was most frequent among patients who received standard-dose therapy, despite the use of GM-CSF. This growth factor has been shown to reduce the severity, duration, and frequency of complications of neutropenia in patients receiving chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) for HIV-related non-Hodgkin's lymphoma.8 Febrile neutropenia was an infrequent complication in this trial, perhaps because GM-CSF shortened the duration of severe neutropenia.
Calculations of relative dose intensity demonstrated that for the most part patients in each of the treatment groups did receive cyclophosphamide and doxorubicin at the planned dose intensity; the patients assigned to the standard-dose group received therapy at approximately twice the dose intensity of those assigned to low-dose therapy. However, patients assigned to standard-dose therapy received methotrexate at less than the planned dose intensity. In some of these cases, the physicians may have chosen to drop methotrexate from a cycle rather than delay the beginning of the next cycle. It is unlikely that this difference affected the outcome, because randomized trials in patients with lymphoma who do not have HIV infection have not demonstrated differences in outcome between CHOP and similar regimens to which methotrexate has been added.17,18
Whether the lymphoma was of the large-cell or small-noncleaved-cell type did not appear to have an effect on survival; this finding confirms those of previous studies in patients with HIV-associated lymphoma.4-6,8 However, the classification of non-Hodgkin's lymphoma in patients with HIV infection is difficult even for experienced pathologists, as illustrated by the pathological review for this study, in which the frequency of disagreement about the subtype of disease between the report of the initial pathologist and that of the central study pathologist was 29 percent.
Our results confirm the impression of many physicians that the use of relatively low doses of chemotherapy does not adversely affect the outcome in patients with HIV-related lymphoma.13 In our experience, low-dose m-BACOD therapy is associated with significantly fewer days of hospitalization than standard-dose therapy. For these reasons, we recommend that low-dose chemotherapy be considered for most patients with HIV infection and non-Hodgkin's lymphoma.
Supported by the National Institute of Allergy and Infectious Diseases ACTG and in part by grants from the National Institutes of Health to Dr. Herndier (CFAR-P30 AI 27763), Dr. Levine (UO1-AI-27573), Dr. Cooley (GCRC-RR00533-28), and Dr. Testa (NIH N01-AAII95030).
We are indebted to Ms. Jessica Ainsworth for her assistance in the preparation of the manuscript.
Source Information
From the Departments of Medicine (L.D.K.) and Pathology (B.H.), San Francisco General Hospital, and the Department of Medicine, University of California, San Francisco (L.D.K., D.W.N.) — both in San Francisco; Memorial Sloan-Kettering Cancer Center and Cornell University Medical College, New York (D.J.S.); the Statistics and Data Analysis Center, Harvard School of Public Health, Boston (M.A.T., J.H.); the Department of Hematology–Oncology, Northwestern University, Chicago (J.V.R.); Beth Israel Deaconess Medical Center, Boston (B.J.D.); the Sections of Hematology and Oncology, Department of Medicine, Boston Medical Center and Boston University School of Medicine, Boston (T.P.C.); and the University of Southern California – Norris Cancer Hospital, University of Southern California School of Medicine, Los Angeles (A.T., A.M.L.).
Address reprint requests to Dr. Kaplan at the University of California, San Francisco – San Francisco General Hospital AIDS Program, Oncology Division, Ward 84, 995 Potrero Ave., San Francisco, CA 94110.
Members of the AIDS Clinical Trials Group and others who worked on this study are listed in the Appendix.
Appendix
The ACTG Protocol 142 investigators who worked on this study included members of the Protocol 142 team, investigators at the National Institute of Allergy and Infectious Diseases (NIAID) AIDS Clinical Trials Units, and investigators at the NIAID Division of AIDS. Additional members of the Protocol 142 team were as follows: M. Niu and G. Galetto, Medical Branch, NIAID, Bethesda, Md.; P. Kasdan, ACTG Operations Center, Bethesda, Md.; M.A. Rice and C.W. Suckow, Frontier Science and Technology Research Foundation, Amherst, N.Y.; C. Caffie, Schering-Plough Corporation, Kenilworth, N.J.; H. Hochster, Department of Medicine, New York University Medical Center, N.Y.; S.G. McCarthy, University of California at Los Angeles Clinical AIDS Research and Education Center, Los Angeles; and I. Fishman, Division of AIDS, NIAID, Bethesda, Md. Additional investigators at NIAID ACTG Units were J. Russell, University of California, San Francisco, and San Francisco General Hospital; D.J. Scadden and B. Chapman, Beth Israel Deaconess Medical Center, Boston; S. Murphy, Northwestern University, Chicago; S. Canmann and S.C. Johnson, University of Colorado, Denver; R. Ambinder and C. Raines, Johns Hopkins University, Baltimore; L. Ratner and M. Gould, Washington University, St. Louis; W.J. Fessel and G. VanRaalte, Stanford University, Stanford, Calif.; P.L. Triozzi and M.F. Para, Ohio State University College of Medicine, Columbus; S.A. Miles and R. Mitsuyasu, University of California at Los Angeles, Los Angeles; A. Greist and J. Craft, Indiana University, Indianapolis; T. Cheung and A. Mercado, Mt. Sinai School of Medicine, New York; D. Biggs and I. Matozzo, University of Pennsylvania, Philadelphia; S. McClure and R. Pollard, University of Texas, Galveston; W.C. Ehmann and J. Zurlo, Hershey Medical Center, Hershey, Pa.; M. Vasquez and J.C. Wernz, George Washington University, Washington, D.C.; J. Bennett and C. Greisberger, University of Rochester, Rochester, N.Y.; H. Ozer, University of North Carolina, Chapel Hill; and M. Carrow and M.C. Pino, Memorial Sloan-Kettering Cancer Center and Cornell University Medical Center, New York.
- References
References
1
Harnly ME ,Swan SH ,Holly EA ,Kelter A ,Padian N . Temporal trends in the incidence of non-Hodgkin's lymphoma and selected malignancies in a population with a high incidence of acquired immunodeficiency syndrome (AIDS). Am J Epidemiol 1988;128:261-267
Web of Science | Medline2
Serraino D ,Salamina G ,Franceschi S , et al. The epidemiology of AIDS-associated non-Hodgkin's lymphoma in the World Health Organization European Region. Br J Cancer 1992;66:912-916
CrossRef | Web of Science | Medline3
Ziegler JL ,Beckstead JA ,Volberding PA , et al. Non-Hodgkin's lymphoma in 90 homosexual men: relation to generalized lymphadenopathy and the acquired immunodeficiency syndrome. N Engl J Med 1984;311:565-570
Full Text | Web of Science | Medline4
Kaplan LD ,Abrams DI ,Feigal E , et al. AIDS-associated non-Hodgkin's lymphoma in San Francisco. JAMA 1989;261:719-724
CrossRef | Web of Science | Medline5
Lowenthal DA ,Straus DJ ,Campbell SW ,Gold JWM ,Clarkson BD ,Koziner B . AIDS-related lymphoid neoplasia: the Memorial Hospital experience. Cancer 1988;61:2325-2337
CrossRef | Web of Science | Medline6
Knowles DM ,Chamulak GA ,Subar M , et al. Lymphoid neoplasia associated with the acquired immunodeficiency syndrome (AIDS): the New York University Medical Center experience with 105 patients (1981-1986). Ann Intern Med 1988;108:744-753
Web of Science | Medline7
Levine AM ,Meyer PR ,Begandy MK , et al. Development of B-cell lymphoma in homosexual men: clinical and immunologic findings. Ann Intern Med 1984;100:7-13
Web of Science | Medline8
Kaplan LD ,Kahn JO ,Crowe S , et al. Clinical and virologic effects of recombinant human granulocyte-macrophage colony-stimulating factor in patients receiving chemotherapy for human immunodeficiency virus-associated non-Hodgkin's lymphoma: results of a randomized trial. J Clin Oncol 1991;9:929-940
Web of Science | Medline9
Levine AM ,Sullivan-Halley J ,Pike MC , et al. Human immunodeficiency virus-related lymphoma: prognostic factors predictive of survival. Cancer 1991;68:2466-2472
CrossRef | Web of Science | Medline10
Gisselbrecht C ,Oksenhendler E ,Tirelli U , et al. Human immunodeficiency virus-related lymphoma treatment with intensive combination chemotherapy. Am J Med 1993;95:188-196
CrossRef | Web of Science | Medline11
Vaccher E ,Tirelli U ,Spina M , et al. Age and serum lactate dehydrogenase level are independent prognostic factors in human immunodeficiency virus-related non-Hodgkin's lymphomas: a single-institute study of 96 patients. J Clin Oncol 1996;14:2217-2223
Web of Science | Medline12
Kaplan LD ,Shiramizu B ,Herndier B , et al. Influence of molecular characteristics on clinical outcome in human immunodeficiency virus-associated non-Hodgkin's lymphoma: identification of a subgroup with favorable clinical outcome. Blood 1995;85:1727-1735
Web of Science | Medline13
Levine AM ,Wernz JC ,Kaplan L , et al. Low-dose chemotherapy with central nervous system prophylaxis and zidovudine maintenance in AIDS-related lymphoma: a prospective multi-institutional trial. JAMA 1991;266:84-88
CrossRef | Web of Science | Medline14
Walsh C ,Wernz JC ,Levine AM , et al. Phase I trial of m-BACOD and granulocyte macrophage colony stimulating factor in HIV-associated non-Hodgkin's lymphoma. J Acquir Immune Defic Syndr 1993;6:265-271
Web of Science | Medline15
Testa MA, Lenderking WR. Quality-of-life considerations in AIDS clinical trials. In: Finkelstein DM, Schoenfeld DA, eds. AIDS clinical trials. New York: Wiley–Liss, 1995:213-41.
16
Gill PS ,Levine AM ,Krailo M , et al. AIDS-related malignant lymphoma: results of prospective treatment trials. J Clin Oncol 1987;5:1322-1328
Web of Science | Medline17
Fisher RI ,Gaynor ER ,Dahlberg S , et al. Comparison of a standard regimen (CHOP) with three intensive chemotherapy regimens for advanced non-Hodgkin's lymphoma. N Engl J Med 1993;328:1002-1006
Full Text | Web of Science | Medline18
Gordon LI ,Harrington D ,Andersen J , et al. Comparison of a second-generation combination chemotherapeutic regimen (m-BACOD) with a standard regimen (CHOP) for advanced diffuse non-Hodgkin's lymphoma. N Engl J Med 1992;327:1342-1349
Full Text | Web of Science | Medline
- Citing Articles (119)
Citing Articles
1
J. A. Rodrigo, L. K. Hicks, M. C. Cheung, K. W. Song, H. Ezzat, C. S. Leger, J. Boro, J. S. G. Montaner, M. Harris, H. A. Leitch. (2012) HIV-Associated Burkitt Lymphoma: Good Efficacy and Tolerance of Intensive Chemotherapy Including CODOX-M/IVAC with or without Rituximab in the HAART Era. Advances in Hematology 2012, 1-9
CrossRef2
Prakash Vishnu, David M. Aboulafia. (2012) AIDS-Related Non-Hodgkin's Lymphoma in the Era of Highly Active Antiretroviral Therapy. Advances in Hematology 2012, 1-9
CrossRef3
Giulia De Falco, Emily A. Rogena, Lorenzo Leoncini. (2011) Infectious agents and lymphoma. Seminars in Diagnostic Pathology 28:2, 178-187
CrossRef4
Tanja Mesti, Tanja Južnič Šetina, Marjeta Vovk, Barbara Jezeršek Novaković. (2011) Eleven years of experience with AIDS-related lymphomas at the Institute of Oncology Ljubljana. Medical Oncology
CrossRef5
Blanca Xicoy, Josep María Ribera, Pilar Miralles, José La Cruz, Albert Oriol, Eulalia Valencia, Mireia Morgades, Beatriz Mahillo, Julián de la Torre, María Jesús Téllez, Salut Brunet, Jordi Esteve, Dieter Hoelzer. (2011) Comparison of CHOP treatment with specific short-intensive chemotherapy in AIDS-related Burkitt's lymphoma or leukemia. Medicina Clínica 136:8, 323-328
CrossRef6
Belinda Lee, Mark Bower, Thomas Newsom-Davis, Mark Nelson. (2010) HIV-related lymphoma. HIV Therapy 4:6, 649-659
CrossRef7
Amrita Krishnan, Joycelynne M. Palmer, John A. Zaia, Ni-Chun Tsai, Joseph Alvarnas, Stephen J. Forman. (2010) HIV Status Does Not Affect the Outcome of Autologous Stem Cell Transplantation (ASCT) for Non-Hodgkin Lymphoma (NHL). Biology of Blood and Marrow Transplantation 16:9, 1302-1308
CrossRef8
Ariela Noy. (2010) Controversies in the treatment of Burkitt lymphoma in AIDS. Current Opinion in Oncology 22:5, 443-448
CrossRef9
David Serrano, Pilar Miralles, Pascual Balsalobre, José Luis Díez-Martin, Juan Berenguer. (2010) Hematopoietic Stem Cell Transplantation in Patients Infected With HIV. Current HIV/AIDS Reports 7:3, 175-184
CrossRef10
Zhi-Yu Chen, Bin Wu, Ji-Liang Yin. (2010) Intensive chemotherapy failure in Burkitt’s lymphoma with cavernous sinus involvement. Medical Oncology 27:2, 327-331
CrossRef11
Michele Spina, Emanuela Chimienti, Ferdinando Martellotta, Emanuela Vaccher, Massimiliano Berretta, Ernesto Zanet, Arben Lleshi, Vincenzo Canzonieri, Pietro Bulian, Umberto Tirelli. (2010) Phase 2 study of intrathecal, long-acting liposomal cytarabine in the prophylaxis of lymphomatous meningitis in human immunodeficiency virus-related non-Hodgkin lymphoma. Cancer 116:6, 1495-1501
CrossRef12
Nadine Housri, Robert Yarchoan, Aradhana Kaushal. (2010) Radiotherapy for patients with the human immunodeficiency virus: Are special precautions necessary?. Cancer 116:2, 273-283
CrossRef13
Paula Yurie Tanaka, Luis Fernando Pracchia, Marcelo Bellesso, Dalton Alencar Fischer Chamone, Edenilson Eduardo Calore, Juliana Pereira. (2010) A prognostic score for AIDS-related diffuse large B-cell lymphoma in Brazil. Annals of Hematology 89:1, 45-51
CrossRef14
Yoon Hee Jun, GoHeun Kim, So Yun Yun, Yook Bum Pyun, Young Chul Moon, Dong Eun Song, Hee Jung Choi. (2010) Cardiac Involvement of Diffuse Large B cell Lymphoma in a Patient with AIDS. Infection and Chemotherapy 42:1, 51
CrossRef15
N. Anthony Othieno Abinya, G. Wanjiru Kiarie, H. Otieno Abwao, Y. Bill Mlombe, R. Omollo. (2009) Outcome of poor prognostic phenotype non-Hodgkin’s lymphoma treatment in relation to human immunodeficiency virus serostatus. Journal africain du cancer / African Journal of Cancer 1:4, 200-206
CrossRef16
Arturo J Martí-Carvajal, Andrés Felipe Cardona, Able Lawrence, Arturo J Martí-Carvajal. 2009. Interventions for previously untreated patients with AIDS-associated Non-Hodgkin´s Lymphoma. .
CrossRef17
R F Ambinder. (2009) The same but different: autologous hematopoietic stem cell transplantation for patients with lymphoma and HIV infection. Bone Marrow Transplantation 44:1, 1-5
CrossRef18
Antonello Malfitano, Giuseppe Barbaro, Giorgio Barbarini. (2009) Ongoing change in the treatment of HIV-associated malignancies in the HAART era. Expert Review of Clinical Pharmacology 2:3, 283-293
CrossRef19
A. Carbone, E. Cesarman, M. Spina, A. Gloghini, T. F. Schulz. (2009) HIV-associated lymphomas and gamma-herpesviruses. Blood 113:6, 1213-1224
CrossRef20
Amrita Krishnan. (2009) HIV-Infected Patients. Biology of Blood and Marrow Transplantation 15:1, 142-145
CrossRef21
Amrita Krishnan. (2009) Stem cell transplantation in HIV-infected patients. Current Opinion in HIV and AIDS 4:1, 11-15
CrossRef22
Alexandra M Levine. (2008) Management of AIDS-related lymphoma. Current Opinion in Oncology 20:5, 522-528
CrossRef23
Amrita Krishnan, Alexandra M Levine. (2008) Malignancies in women with HIV infection. Women's Health 4:4, 357-368
CrossRef24
Lawrence D. Kaplan. 2008. HIV-associated Neoplasia. , 463-474.
CrossRef25
L. Galicier, C. Fieschi, R. Borie, V. Meignin, M.-T. Daniel, L. Gerard, E. Oksenhendler. (2007) Intensive chemotherapy regimen (LMB86) for St Jude stage IV AIDS-related Burkitt lymphoma/leukemia: a prospective study. Blood 110:8, 2846-2854
CrossRef26
Joseph A Sparano. (2007) HIV-associated lymphoma: the evidence for treating aggressively but with caution. Current Opinion in Oncology 19:5, 458-463
CrossRef27
Matthew C. Cheung, Kevin R. Imrie, Heather A. Leitch, Laura Y. Park-Wyllie, Rena Buckstein, Tony Antoniou, Mona R. Loutfy. (2007) Physician perceptions and preferences in the treatment of acquired immunodeficiency syndrome (AIDS)-related lymphoma. Annals of Hematology 86:9, 631-638
CrossRef28
Jeffrey S. Stroup, Bridget A. Bransteitter, Johnny R. Stephens, Scott E. Hendrickson. (2007) Burkitt Lymphoma in an Adult HIV-Positive Patient. Infectious Diseases in Clinical Practice 15:2, 116-118
CrossRef29
Nicolas Mounier, Michele Spina, Christian Gisselbrecht. (2007) Modern management of non-Hodgkin lymphoma in HIV-infected patients. British Journal of Haematology 136:5, 685-698
CrossRef30
Pilar Miralles, Juan Berenguer, Jos?? Mar??a Ribera, Rafael Rubio, Beatriz Mahillo, Mar??a Jes??s T??llez, Jos?? Lacruz, Eulalia Valencia, Jes??s Santos, Francisco Rodr??guez-Arrondo, Vicente Pintado. (2007) Prognosis of AIDS-Related Systemic Non-Hodgkin Lymphoma Treated With Chemotherapy and Highly Active Antiretroviral Therapy Depends Exclusively on Tumor-Related Factors. JAIDS Journal of Acquired Immune Deficiency Syndromes 44:2, 167-173
CrossRef31
Olga M Klibanov, Rachel Clark-Vetri. (2007) Oncologic Complications of Human Immunodeficiency Virus Infection: Changing Epidemiology, Treatments, and Special Considerations in the Era of Highly Active Antiretroviral Therapy. Pharmacotherapy 27:1, 122-136
CrossRef32
D.E. HERNÀNDEZ, A.E. HERNÀNDEZ. (2006) Human immunodeficiency virus-associated diffuse non-Hodgkin's lymphoma in Venezuelan patients: treatment with full-dose cyclophosphamide-doxorubicin-vincristine-prednisone without routine use of granulocyte-colony stimulating factor. European Journal of Cancer Care 15:5, 493-496
CrossRef33
Quentin A. Hill, Roger G. Owen. (2006) CNS prophylaxis in lymphoma: Who to target and what therapy to use. Blood Reviews 20:6, 319-332
CrossRef34
Caroline M Behler, Lawrence D Kaplan. (2006) Advances in the management of HIV-related non-Hodgkin lymphoma. Current Opinion in Oncology 18:5, 437-443
CrossRef35
Catherine Diamond, Thomas H Taylor, Theresa Im, Mohammed Miradi, Hoda Anton-Culver. (2006) Improved survival and chemotherapy response among patients with AIDS-related non-Hodgkin's lymphoma receiving highly active antiretroviral therapy. Hematological Oncology 24:3, 139-145
CrossRef36
R. Trappe, S. Oertel, H. Riess. (2006) HIV-assoziierte Lymphome und Posttransplantationslymphome. Der Onkologe 12:7, 641-650
CrossRef37
Rudolf Weiss, Paris Mitrou, Keikawus Arasteh, Dirk Schuermann, Marcus Hentrich, Ulrich Duehrsen, Hinrich Sudeck, Ingo G. H. Schmidt-Wolf, Ioannis Anagnostopoulos, Dieter Huhn. (2006) Acquired immunodeficiency syndrome-related lymphoma. Cancer 106:7, 1560-1568
CrossRef38
John Gerecitano, David J Straus. (2006) Treatment of Burkitt lymphoma in adults. Expert Review of Anticancer Therapy 6:3, 373-381
CrossRef39
Danish Mazhar, Justin Stebbing, Mark Bower. (2006) Non-Hodgkin’s lymphoma and the CNS: prophylaxis and therapy in immunocompetent and HIV-positive individuals. Expert Review of Anticancer Therapy 6:3, 335-341
CrossRef40
Catherine Diamond, Thomas H. Taylor, Theresa Im, Hoda Anton-Culver. (2006) Presentation and outcomes of systemic non-Hodgkin's lymphoma: A comparison between patients with acquired immunodeficiency syndrome (AIDS) treated with highly active antiretroviral therapy and patients without AIDS. Leukemia & Lymphoma 47:9, 1822-1829
CrossRef41
Kyung Mi Kang, Do Seon Song, Jin Min Park, Chan-Kwon Jung, Young Seon Hong, Moon Won Kang, Chong Won Park. (2006) Four Cases of Non-Hodgkin's Lymphoma in AIDS patients. The Korean Journal of Internal Medicine 21:4, 266
CrossRef42
Michele Spina, Umberto Tirelli. (2005) Rituximab for HIV-associated lymphoma: weighing the benefits and risks. Current Opinion in Oncology 17:5, 462-465
CrossRef43
Tiziana Benicchi, Claudia Ghidini, Alessandro Re, Chiara Cattaneo, Salvatore Casari, Luigi Caimi, Giuseppe Rossi, Luisa Imberti. (2005) T-Cell Immune Reconstitution after Hematopoietic Stem Cell Transplantation for HIV-Associated Lymphoma. Transplantation 80:5, 673-682
CrossRef44
Robert Yarchoan, Giovanna Tosato, Richard F Little. (2005) Therapy Insight: AIDS-related malignancies—the influence of antiviral therapy on pathogenesis and management. Nature Clinical Practice Oncology 2:8, 406-415
CrossRef45
Arturo J Martí-Carvajal, Sergio R. Munoz, Arturo J Martí-Carvajal. 2005. Interventions for treating AIDS-associated Non-Hodgkin´s Lymphoma (NHL) in treatment-naive adults with AIDS. .
CrossRef46
Timo Wolf, Hans-Reinhard Brodt, Stephan Fichtlscherer, Kathleen Mantzsch, Dieter Hoelzer, Eilke Helm, Paris Mitrou, Kai Uwe Chow. (2005) Changing incidence and prognostic factors of survival in AIDS-related non-Hodgkin's lymphoma in the era of highly active antiretroviral therapy (HAART). Leukemia & Lymphoma 46:2, 207-215
CrossRef47
Tony Antoniou, Alice L Tseng. (2005) Interactions Between Antiretrovirals and Antineoplastic Drug Therapy. Clinical Pharmacokinetics 44:2, 111-145
CrossRef48
Asher Chanan-Khan, Beata Holkova, Alec S Goldenberg, Anna Pavlick, Rita Demopoulos, Kenichi Takeshita. (2005) Non-Hodgkin's lymphoma presenting as a breast mass in patients with HIV infection: A report of three cases. Leukemia & Lymphoma 46:8, 1189-1193
CrossRef49
Alison Clayton, Tariq Mughal. (2004) The changing face of HIV-associated lymphoma: what can we learn about optimal therapy inl the post highly active antiretroviral therapy era?. Hematological Oncology 22:3, 111-120
CrossRef50
Jackson Orem, Mwanda W Otieno, Scot C Remick. (2004) AIDS-associated cancer in developing nations. Current Opinion in Oncology 16:5, 468-476
CrossRef51
Yvette L Kasamon, Lode J Swinnen. (2004) Treatment advances in adult Burkitt lymphoma and leukemia. Current Opinion in Oncology 16:5, 429-435
CrossRef52
Justin Stebbing, Vanessa Marvin, Mark Bower. (2004) The evidence-based treatment of AIDS-related non-Hodgkin’s lymphoma. Cancer Treatment Reviews 30:3, 249-253
CrossRef53
R
gis T. Costello, Hac
CrossRef54
Arturo Molina, John Zaia, Amrita Krishnan. (2003) Treatment of human immunodeficiency virus-related lymphoma with haematopoietic stem cell transplantation. Blood Reviews 17:4, 249-258
CrossRef55
E. Vaccher, M. Spina, R. Talamini, M. Zanetti, G. di Gennaro, G. Nasti, M. Tavio, D. Bernardi, C. Simonelli, U. Tirelli. (2003) Improvement of Systemic Human Immunodeficiency Virus--Related Non-Hodgkin Lymphoma Outcome in the Era of Highly Active Antiretroviral Therapy. Clinical Infectious Diseases 37:11, 1556-1564
CrossRef56
Robert Marcus. (2003) Current Treatment Options in Aggressive Lymphoma. Leukemia & Lymphoma 44:S4, S15-S27
CrossRef57
Richard F Little. (2003) AIDS-related Non-Hodgkin's Lymphoma: Etiology, Epidemiology, and Impact of Highly Active Antiretroviral Therapy. Leukemia & Lymphoma 44:S3, S63-S68
CrossRef58
Cabot, Richard C.Harris, Nancy Lee, McNeely, William F., Shepard, Jo-Anne O., Ebeling, Sally H.Ellender, Stacey M.Peters, Christine C., Kaplan, Lawrence D., Afridi, Nadeem A., Holmvang, Godtfred, Zukerberg, Lawrence R., . (2003) Case 31-2003. New England Journal of Medicine 349:14, 1369-1377
Full Text59
Eunice S. Wang, David J. Straus, Julie Teruya-Feldstein, Jing Qin, Carol Portlock, Craig Moskowitz, Andre Goy, Eric Hedrick, Andrew D. Zelenetz, Ariela Noy. (2003) Intensive chemotherapy with cyclophosphamide, doxorubicin, high-dose methotrexate/ifosfamide, etoposide, and high-dose cytarabine (CODOX-M/IVAC) for human immunodeficiency virus-associated Burkitt lymphoma. Cancer 98:6, 1196-1205
CrossRef60
Alexandra M Levine. (2003) The treatment of AIDS-related cancers. The Lancet Oncology 4:9, 576-581
CrossRef61
Alan B. Astrow, Grace Tarabay, Vincent E. Salerno, William A. Cook, Robert Lin, Steven Lascher, Zujun Li, Amitabha Mazumder, Ira Halperin, John Cho, Zulfaqquar Jaffar, Marilyn McLaughlin, Ronald H. Blum, Sanford J. Kempin. (2003) Long-term survival in patients with human immunodeficiency virus-associated small non-cleaved cell lymphoma: the role for short course intensive chemotherapy. Hematological Oncology 21:3, 131-140
CrossRef62
Ingo GH Schmidt-Wolf, Jürgen K Rockstroh, Uwe Schlegel, Hendrik Pels, Ulrich Mey, John Strehl, Rudolf Weiss, Dieter Huhn. (2003) Treatment options of AIDS-related lymphoma. Expert Opinion on Pharmacotherapy 4:8, 1331-1343
CrossRef63
Amy E Gates, Lawrence D Kaplan. (2003) Biology and management of aids-associated non-hodgkin's lymphoma. Hematology/Oncology Clinics of North America 17:3, 821-841
CrossRef64
Debashish Sarker, Christina Thirlwell, Mark Nelson, Brian Gazzard, Mark Bower. (2003) Leptomeningeal disease in AIDS-related non-Hodgkin's lymphoma. AIDS 17:6, 861-865
CrossRef65
Richard F. Little, Robert Yarchoan. (2003) Treatment of gammaherpesvirus-related neoplastic disorders in the immunosuppressed host. Seminars in Hematology 40:2, 163-171
CrossRef66
Richard F. Little, Wyndham H. Wilson. (2003) Update on the pathogenesis, diagnosis, and therapy of AIDs-related lymphoma. Current Infectious Disease Reports 5:2, 176-184
CrossRef67
David T. Scadden. (2003) AIDS-Related Malignancies. Annual Review of Medicine 54:1, 285-303
CrossRef68
Michele Spina, Joseph A Sparano, Ulrich Jaeger, Giuseppe Rossi, Umberto Tirelli. (2003) Rituximab and chemotherapy is highly effective in patients with CD20-positive non-Hodgkin's lymphoma and HIV infection. AIDS 17:1, 137-138
CrossRef69
Amrita Krishnan, John Zaia, Arturo Molina. (2002) Stem Cell Transplantation and Gene Therapy for HIV-Related Lymphomas. Journal of Hematotherapy <html_ent glyph="@amp;" ascii="&"/> Stem Cell Research 11:5, 765-775
CrossRef70
CHRIS THEODOSSIOU, PAUL SCHWARZENBERGER. (2002) Non-Hodgkin's Lymphomas. Clinical Obstetrics and Gynecology 45:3, 820-829
CrossRef71
Laurence Gérard, Lionel Galicier, Anne Maillard, Emmanuelle Boulanger, Laurent Quint, Sophie Matheron, Bernard Cardon, Véronique Meignin, Eric Oksenhendler. (2002) Systemic Non-Hodgkin Lymphoma in HIV-Infected Patients With Effective Suppression of HIV Replication: Persistent Occurrence But Improved Survival. JAIDS Journal of Acquired Immune Deficiency Syndromes 30:5, 478-484
CrossRef72
&NA;. (2002) AIDS-related lymphoma: will new treatments make up for the shortfalls of current therapy?. Drugs & Therapy Perspectives 18:8, 13-17
CrossRef73
David M. Aboulafia. (2002) HHV-8- and EBV-Associated Nonepidermotrophic Large B-Cell Lymphoma Presenting as a Foot Rash in a Man with AIDS. AIDS Patient Care and STDs 16:4, 139-145
CrossRef74
Regis A. Vilchez, Claudia A. Kozinetz, Jeffrey L. Jorgensen, Michael H. Kroll, Janet S. Butel. (2002) AIDS-Related Systemic Non-Hodgkin's Lymphoma at a Large Community Program. AIDS Research and Human Retroviruses 18:4, 237-242
CrossRef75
Jorge Cortes, Deborah Thomas, Adan Rios, Charles Koller, Susan O'Brien, Sima Jeha, Stefan Faderl, Hagop Kantarjian. (2002) Hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone and highly active antiretroviral therapy for patients with acquired immunodeficiency syndrome-related burkitt lymphoma/leukemia. Cancer 94:5, 1492-1499
CrossRef76
Umberto Tirelli, Daniele Bernardi, Michele Spina, Emanuela Vaccher. (2002) AIDS-related tumors: integrating antiviral and anticancer therapy. Critical Reviews in Oncology/Hematology 41:3, 299-315
CrossRef77
Alexandra M. Levine, Saeed Sadeghi, Byron Espina, Anil Tulpule, Bharat Nathwani. (2002) Characteristics of indolent non-hodgkin lymphoma in patients with type 1 human immunodeficiency virus infection. Cancer 94:5, 1500-1506
CrossRef78
Anil Tulpule, Andy Sherrod, Dharshika Dharmapala, Lillian L Young, Byron M Espina, Maria Norilyn Sanchez, Parkash S Gill, Alexandra M Levine. (2002) Multidrug resistance (MDR-1) expression in aids-related lymphomas. Leukemia Research 26:2, 121-127
CrossRef79
Alexandra M. Levine. 2002. Neoplasms in Acquired Immunodeficiency Syndrome. , 297-302.
CrossRef80
Jia Bi, Byron M. Espina, Anil Tulpule, William Boswell, Alexandra M. Levine. (2001) High-Dose Cytosine–Arabinoside and Cisplatin Regimens as Salvage Therapy for Refractory or Relapsed AIDS-Related Non-Hodgkin's Lymphoma. JAIDS Journal of Acquired Immune Deficiency Syndromes 28:5, 416-421
CrossRef81
R. Colebunders, P. Michielsen. (2001) Diagnosis at first glance: nodular hepatic lesions in persons with AIDS. Clinical Microbiology and Infection 7:10, 576-577
CrossRef82
Andrea Antinori, Antonella Cingolani, Lucia Alba, Adriana Ammassari, Diego Serraino, Bruno C. Ciancio, Fabrizio Palmieri, Andrea De Luca, Luigi M. Larocca, Luigi Ruco, Giuseppe Ippolito, Roberto Cauda. (2001) Better response to chemotherapy and prolonged survival in AIDS-related lymphomas responding to highly active antiretroviral therapy. AIDS 15:12, 1483-1491
CrossRef83
Michele Spina, Emanuela Vaccher, Senka Juzbasic, Isabella Milan, Guglielmo Nasti, Renato Talamini, Marco Fasan, Andrea Antinori, Ezio Nigra, Umberto Tirelli. (2001) Human immunodeficiency virus-related non-Hodgkin lymphoma. Cancer 92:1, 200-206
CrossRef84
J Sparano. (2001) Clinical aspects and management of AIDS-related lymphoma. European Journal of Cancer 37:10, 1296-1305
CrossRef85
Michele Spina, Emanuela Vaccher, Senka Juzbasic, Isabella Milan, Guglielmo Nasti, Renato Talamini, Marco Fasan, Andrea Antinori, Ezio Nigra, Umberto Tirelli. (2001) Human immunodeficiency virus-related non-Hodgkin lymphoma. Cancer 92:1, 200-206
CrossRef86
Michele Spina, Emanuela Vaccher, Senka Juzbasic, Isabella Milan, Guglielmo Nasti, Renato Talamini, Marco Fasan, Andrea Antinori, Ezio Nigra, Umberto Tirelli. (2001) Human immunodeficiency virus-related non-Hodgkin lymphoma. Cancer 92:1, 200-206
CrossRef87
Michele Spina, Emanuela Vaccher, Senka Juzbasic, Isabella Milan, Guglielmo Nasti, Renato Talamini, Marco Fasan, Andrea Antinori, Ezio Nigra, Umberto Tirelli. (2001) Human immunodeficiency virus-related non-Hodgkin lymphoma. Cancer 92:1, 200-206
CrossRef88
Michele Spina, Emanuela Vaccher, Senka Juzbasic, Isabella Milan, Guglielmo Nasti, Renato Talamini, Marco Fasan, Andrea Antinori, Ezio Nigra, Umberto Tirelli. (2001) Human immunodeficiency virus-related non-Hodgkin lymphoma. Cancer 92:1, 200-206
CrossRef89
Michele Spina, Emanuela Vaccher, Senka Juzbasic, Isabella Milan, Guglielmo Nasti, Renato Talamini, Marco Fasan, Andrea Antinori, Ezio Nigra, Umberto Tirelli. (2001) Human immunodeficiency virus-related non-Hodgkin lymphoma. Cancer 92:1, 200-206
CrossRef90
David J. Straus. (2001) HIV-Associated lymphomas. Current Oncology Reports 3:3, 260-265
CrossRef91
Mwanda W. Otieno, Scot C. Remick, Christopher Whalen. (2001) Adult Burkitt's lymphoma in patients with and without human immunodeficiency virus infection in Kenya. International Journal of Cancer 92:5, 687-691
CrossRef92
Scot C. Remick, Nell Sedransk, Richard F. Haase, Christina G. Blanchard, Carm R. Ramnes, Tipu Nazeer, David M. Mastrianni, Bruce J. Dezube. (2001) Oral combination chemotherapy in conjunction with filgrastim (G-CSF) in the treatment of AIDS-related non-Hodgkin's lymphoma: Evaluation of the role of G-CSF; Quality-of-life analysis and long-term follow-up. American Journal of Hematology 66:3, 178-188
CrossRef93
Mark Bower. (2001) Acquired immunodeficiency syndrome-related systemic non-Hodgkin's lymphoma. British Journal of Haematology 112:4, 863-873
CrossRef94
Jose-Tomas Navarro, Josep-Maria Ribera, Albert Oriol, Manuel Vaquero, Joan Romeu, Montserrat Batlle, Alonso Flores, Fuensanta Milla, Evarist Feliu. (2001) Influence of highly active anti-retroviral therapy on response to treatment and survival in patients with acquired immunodeficiency syndrome-related non-Hodgkin's lymphoma treated with cyclophosphamide, hydroxydoxorubicin, vincristine and prednisone. British Journal of Haematology 112:4, 909-915
CrossRef95
Kai U. Chow, Paris S. Mitrou, Kerstin Geduldig, Eilke B. Helm, Dieter Hoelzer, H. Reinhard Brodt. (2001) Changing Incidence and Survival in Patients with AIDS-Related Non-Hodgkin's Lymphomas in the Era of Highly Active Antiretroviral Therapy (HAART). Leukemia & Lymphoma 41:1-2, 105-116
CrossRef96
Emanuela Vaccher, Michele Spina, Giampiero di Gennaro, Renato Talamini, Guglielmo Nasti, Ornella Schioppa, Giuseppe Vultaggio, Umberto Tirelli. (2001) Concomitant cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy plus highly active antiretroviral therapy in patients with human immunodeficiency virus-related, non-Hodgkin lymphoma. Cancer 91:1, 155-163
CrossRef97
Marie Jos?? Kersten, Rien H.J. Van Oers. (2001) Management of AIDS-Related Non-Hodgkin??s Lymphomas. Drugs 61:9, 1301-1315
CrossRef98
Paula G. O'Connor, David T. Scadden. (2000) AIDS ONCOLOGY. Infectious Disease Clinics of North America 14:4, 945-965
CrossRef99
Richard F. Little, Robert Yarchoan, Wyndham H. Wilson. (2000) Systemic chemotherapy for HIV-associated lymphoma in the era of highly active antiretroviral therapy. Current Opinion in Oncology 12:5, 438-444
CrossRef100
Richard F. Ambinder. (2000) New controversies and new directions. Current Opinion in Oncology 12:5, 435-437
CrossRef101
Umberto Tirelli, Michele Spina, Gianluca Gaidano, Emanuela Vaccher, Silvia Franceschi, Antonino Carbone. (2000) Epidemiological, biological and clinical features of HIV-related lymphomas in the era of highly active antiretroviral therapy. AIDS 14:12, 1675-1688
CrossRef102
Arturo Molina, Amrita Y. Krishnan, Auayporn Nademanee, Rachel Zabner, Irena Sniecinski, John Zaia, Stephen J. Forman. (2000) High dose therapy and autologous stem cell transplantation for human immunodeficiency virus-associated non-Hodgkin lymphoma in the era of highly active antiretroviral therapy. Cancer 89:3, 680-689
CrossRef103
Bernard Couderc, Jean-Pierre Dujols, Fatma Mokhtari, Jean-Luc Norkowski, Jean-Claude Slawinski, Daniel Schlaifer. (2000) The management of adult aggressive non-Hodgkin’s lymphomas. Critical Reviews in Oncology/Hematology 35:1, 33-48
CrossRef104
Christopher W Lee, Kim N Chi. (2000) The standard of reporting of health-related quality of life in clinical cancer trials. Journal of Clinical Epidemiology 53:5, 451-458
CrossRef105
Frantz Thiessard, Philippe Morlat, Catherine Marimoutou, Eric Labouyrie, Jean-Marie Ragnaud, Jean-Luc Pellegrin, Michel Dupon, Fran
CrossRef106
Schmidt, Wolfgang, Anagnostopoulos, Ioannis, Scherübl, Hans, . (2000) Virostatic Therapy for Advanced Lymphoproliferation Associated with the Epstein–Barr Virus in an HIV-Infected Patient. New England Journal of Medicine 342:6, 440-441
Full Text107
Eric Oksenhendler, Laurence Gerard, Marie-Laure Dubreuil, Yves Levy, Sophie Matheron, Dominique Cazals-Hatem, Sylvie Chevret, Jean-Pierre Clauvel. (2000) Intensive Chemotherapy (LNHIV-91 Regimen) and G-CSF for HIV Associated Non-Hodgkin's Lymphoma. Leukemia & Lymphoma 39:1-2, 87-95
CrossRef108
P. Herranz, J.R. Arribas, A. Navarro, J.M. Pena, J. Gonzalez, F.A. Rubio, M. Casado. (2000) Successful treatment of aphthous ulcerations in AIDS patients using topical granulocyte-macrophage colony-stimulating factor. British Journal of Dermatology 142:1, 171-176
CrossRef109
Sherif B. Mossad, J. Walton Tomford, Robin K. Avery, Mohamad A. Hussein, Kenneth W. Vaughn. (2000) Isolated primary hepatic lymphoma in a patient with acquired immunodeficiency syndrome. International Journal of Infectious Diseases 4:1, 57-58
CrossRef110
Giuseppe Rossi, Alessandra Donisi, Salvatore Casari, Alessandro Re, GianPiero Cadeo, Giampiero Carosi. (1999) The International Prognostic Index can be used as a guide to treatment decisions regarding patients with human immunodeficiency virus?related systemic non-Hodgkin lymphoma. Cancer 86:11, 2391-2397
CrossRef111
Jigna Desai, Robin J. Mitnick, David H. Henry, Josefina Llena, Joseph A. Sparano. (1999) Patterns of central nervous system recurrence in patients with systemic human immunodeficiency virus-associated non-Hodgkin lymphoma. Cancer 86:9, 1840-1847
CrossRef112
Robert A. Baiocchi, Michael A. Caligiuri. (1999) Cytokines in the evolution and treatment of AIDS-lymphoma. Current Opinion in Oncology 11:6, 516
CrossRef113
P. Campbell, H. Iland, J. Gibson, D. Joshua. (1999) Syngeneic stem cell transplantation for HIV-related lymphoma. British Journal of Haematology 105:3, 795-798
CrossRef114
J. Evison, J. Jost, B. Ledergerber, L. Jost, F. Strasser, R. Weber. (1999) HIV-associated non-Hodgkin‚s lymphoma: highly active antiretroviral therapy improves remission rate of chemotherapy. AIDS 13:6, 732
CrossRef115
David T. Scadden, David P. Schenkein, Zale Bernstein, Barry Luskey, John Doweiko, Anil Tulpule, Alexandra M. Levine. (1998) Immunotoxin combined with chemotherapy for patients with AIDS-related non-Hodgkin's lymphoma. Cancer 83:12, 2580-2587
CrossRef116
Michele Spina, Umberto Tirelli, Vittorina Zagonel, Annunziata Gloghini, Rachele Volpe, Roberta Babare, Luciano Abbruzzese, Renato Talamini, Emanuela Vaccher, Antonino Carbone. (1998) Burkitt's lymphoma in adults with and without human immunodeficiency virus infection. Cancer 82:4, 766-774
CrossRef117
Clay Smith, Scott Lilly, Karen P Mann, Elizabeth Livingston, Sarah Myers, H Kim Lyerly, G Diego Miralles. (1998) AIDS-related malignancies. Annals of Medicine 30:4, 323-344
CrossRef118
(1997) Chemotherapy for AIDS-Related Lymphomas. New England Journal of Medicine 337:16, 1172-1174
Full Text119
C.P. Cottrill, D.M. Bottomley, R.H. Phillips. (1997) Cancer and HIV infection. Clinical Oncology 9:6, 365-380
CrossRef
- Letters
