Treatment outcome in presumed and confirmed AIDS-related primary cerebral lymphoma |
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| Affiliation: | 1. Department of Oncology, Chelsea & Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK;2. Department of HIV Medicine, Chelsea & Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK;3. Department of Virology, University College London Medical School, London, UK;1. Assistant Professor (Microbiology), Command Hospital (Southern Command), Pune 411040, India;2. Brig Med, HQ 15 Corps, C/o 56 APO, India;3. Col Med, 3 Inf Div, C/o 56 APO, India;4. Junior Consultant (Microbiology), Sahyadri Speciality Hospital, Pune, India;5. Assistant Professor (Microbiology), Dr. DY Patil Medical College, Pune, India;6. Assistant Professor, Department of Transfusion Medicine, Armed Forces Medical College, Pune 411040, India;1. Military Veterinary Institute, Academy of Military Medical Sciences, Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Key Laboratory of Zoonosis Research, Ministry of Education, Changchun, China;2. State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China;3. College of Life Science, Jilin Agricultural University, Changchun, China;1. Department of Child Health, Faculty of Medicine, Universitas Indonesia, Jl. Salemba Raya No. 6, Senen, Jakarta Pusat, Jakarta, 10430, Indonesia;2. Faculty of Medicine, Universitas Indonesia, Jl. Salemba Raya No. 6, Senen, Jakarta Pusat, Jakarta, 10430, Indonesia;1. Department of Microbiology and Parasitology, Anhui Province Key Laboratory of Microbiology and Parasitology, The Key Laboratory of Zoonoses of High Institutions in Anhui, School of Basic Medical Sciences, Anhui Medical University, Hefei, 230032, China;2. Department of Clinical Laboratory, Taihe People''s Hospital, Fuyang, 236600, China;3. School of Life Sciences, Key Laboratory of Human Microenvironment and Precision Medicine of Anhui Higher Education Institutes, Anhui University, Hefei, 230032, China |
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| Abstract: | A retrospective analysis identified 38 HIV seropositive patients with a diagnosis of presumed (n=26) or confirmed (n=12) primary cerebral lymphoma (PCNSL). All patients had failed to respond to empirical antitoxoplasma therapy and the clinical diagnosis of PCNSL was confirmed by brain biopsy (n=4), cerebrospinal fluid (CSF) examination for Epstein–Barr virus (EBV) by PCR (n=7) or postmortem examination (n=1). There was no difference in the age, performance status, CD4 counts, antiretroviral usage or interval since first HIV serodiagnosis between patients with presumed or confirmed PCNSL. 16 patients received either radiotherapy (n=14) or chemotherapy (n=2). Patients with confirmed or presumptive PCNSL were equally likely to receive treatment. The median overall survival, which was measured from the end of unsuccessful antitoxoplasma therapy, was 1.2 months for the whole cohort. There was no difference in overall survival between patients with presumptive (median 0.8 months) and confirmed (median 1.3 months) PCNSL (logrank P=0.69). This suggests that there may be little value in positively diagnosing PCNSL in the current diagnostic algorithm. Recent improvements in outcome have been reported with systemic chemotherapy in HIV-PCNSL and may influence the need for earlier definitive diagnosis in the future. |
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