HAART prolongs survival in AIDS-related primary CNS lymphoma
In patients with AIDS-related primary central nervous system lymphoma (PCNSL), subsequent treatment with highly active antiretroviral therapy is associated with significantly longer survival, physicians report in the August 15th issue of AIDS.
Before HAART was available, patients rarely survived more than 3 months after diagnosis of PCNSL. Because the role of HAART in treatment of PCNSL is not clear, Drs. Daniel J. Skiest and Craig Crosby, of The University of Texas Southwestern Medial Center in Dallas, examined 25 AIDS patients diagnosed with PCNSL between 1995 and 2001. None of the patients was treated with chemotherapy. Among the 18 individuals not prescribed HAART, median survival was 52 days. Six of these individuals received radiation therapy, and their median survival was 170 days.Seven patients were treated with HAART and radiation therapy, one of whom survived for only 87 days. The other six were still alive at follow-up times ranging from 7.5 to over 70 months. Survival was not associated with year of diagnosis, HIV viral load, tumor histology, or age. Dr. Skiest and Dr. Crosby suggest that outcomes can be improved by prompt diagnosis, aggressive HAART and chemotherapy, along with treatments that directly target Epstein-Barr virus. However, the use of cranial radiation should be further evaluated, they maintain, since it is associated with such severe side effects as visual loss, recurrent seizures and encephalomalacia. (Source: AIDS 2003;17:1787-1793: Reuters Health: July 31, 2003: Oncolink)