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Background. In a prospective randomized manner, this study evaluated the effect of adjuvant chemotherapy (cyclophosphamide, doxorubicin, vincristine, and prednisone; CHOP) in patients with Stage I non-Hodgkin lymphoma (NHL) who have achieved a complete response (CR) after radiation therapy (RT). Methods. Forty-four patients with clinical or pathologic Stage I intermediate-grade or low-grade NHL were randomized to receive regional RT alone (median dose, 40 Gy) or regional RT followed by six cycles of CHOP chemotherapy. There were no differences in clinical and pathologic characteristics between the two treatment groups. Results. The median follow-up was 7 years (range, 2-10 years). The actuarial relapse-free survival (RFS) rate for the RT plus CHOP group at 7 years was 83% compared with 47% (P < 0.03) for the RT-alone group. The overall survival (OS) for the two groups was 88% and 66%, respectively (P = 0.2). In patients with intermediate-grade NHL, the 7-year actuarial RFS for RT and CHOP was 86% compared with 20% for RT alone (P = 0.004). The corresponding actuarial survival rates were 92% and 47%, respectively (P = 0.08). In patients with low-grade histologic findings, the addition of adjuvant CHOP did not improve RFS (P = 0.6) or OS. All relapses in this study were at sides remote from the initially involved areas, and in 5 of 11 patients (45%), there were recurrences 5 years or longer after initial treatment. Conclusions. This study showed that adjuvant CHOP chemotherapy significantly improves RFS in patients with Stage I intermediate-grades NHL who achieve a CR after regional-field RT. The chemotherapeutic, regimen favorably affected their probability of survival. Cancer 1993; 71:2342-50.

PURPOSE: Small non-cleaved-cer lymphoma (SNCL) 'Burkitt's type,' a rapidly growing lymphoma, has been rare among adults in the United States, but has greatly increased in incidence with the acquired immunodeficiency syndrome epidemic. This report details the results of treatment of adult SNCL with a series of protocols originally designed for the treatment of acute lymphoblastic leukemia ALL). PATIENTS AND METHODS: Between July 1973 and May 1987, 29 adults with newly diagnosed SNCL were treated at Memorial Hospital with intensive chemotherapy or designed for ALL, the cyclophosphamide L-2, L-10, L-17, and L-20 protocols. Nine patients had positive serologies for human immminodeficiency virus HIV) infection. One patient with all measurable disease resected was not evaluable for response. RESULTS: Sixteen of 28 evaluable patients (57%) achieved a complete remission with treatment. With follow-up as long as 153 months (median, 47 months), 50% of allpatients and 59% of patients with negative or uknown HIV serologies have survived and are probably cured. Patients with an initial serum lactic acid dehydrogenase (LDH) level of greater than 500 U/L had a significantly shortened survival as compared with those with a lower serum LDH Other pretreatment patient characteristics associated with a shortened survival of borderline statistical significance were high National Cancer Institute stage (C, D) and bone marrow involvement. These results are similar to those for all and lymphoblastic lymphoma and are comparable to those for American SNCL in the literature. CONCLUSIONS- Approximately one half of adults with SNCL are curable with intensive chemotherapy. More intensive chemotherapy with hematopoietic growth factor and/or autologous bone marrow or peripheral stem cell support may increase curability., Small non-cleaved-cell lymphoma (SNCL), also referred to as Burkitt's type lymphoma, is a rapidly growing cancer of the lymphoid tissue which rarely occurs in adults in the United States. However, the incidence of SNCL among adults has increased with the AIDS epidemic. The effectiveness of a drug regimen used to treat acute lymphoblastic leukemia (ALL), another cancer of the blood, was assessed in 28 patients with SNCL. Nine patients had evidence of infection with the human immunodeficiency virus (HIV), which causes AIDS. The drug regimen designed for ALL consisted of the anticancer agent, cyclophosphamide, in the L-2, L-10, L-17, and L-20 protocols. Complete remission was achieved in 16 of 28 patients (57 percent). Fifty percent of all patients and 59 percent of patients with no known HIV disease had survived 47 months and were probably cured at the time of publication. A shorter duration of survival was associated with: levels of the enzyme, lactic acid dehydrogenase, that were greater than 500 units per liter; advanced stages of cancer; and involvement of the bone marrow. These findings show that intensive chemotherapy is effective in treating about 50 percent of patients with SNCL. Therapy that enhances bone marrow function, such as hematopoietic growth factor, may improve treatment of SNCL. (Consumer Summary produced by Reliance Medical Information, Inc.)

Infection with human immunodeficiency virus (HIV) results in the deterioration of the immune system, thereby increasing the risk of developing opportunistic infections and malignancies. HIV-related cancers include Kaposi's sarcoma, lymphoma of the central nervous system, undifferentiated Hodgkin's lymphoma, squamous cell carcinoma, anorectal carcinoma, and a variety of skin cancers. These cancers occur with the same incidence observed in patients with abnormal immune systems resulting from congenital disorders, drugs to prevent graft rejection (used with organ transplant recipients), or autoimmune diseases. Lymphoma, or cancer of the lymphoid system, occurs in more aggressive disease states. It is often diagnosed at an advanced stage, involves body sites in addition to the lymph nodes, and does not respond well to anticancer agents. The origin and development of lymphoma and other cancers in HIV-infected patients may be related to infection with a virus, such as the Epstein-Barr virus or papillomavirus. The distribution and characteristics of lymphoma and other HIV-related malignancies are described. (Consumer Summary produced by Reliance Medical Information, Inc.)

Background. Zidovudine is a thymidine analogue that has been reported to have antiviral and antineoplastic activity in vitro. Methods. The case of a patient with acquired immune deficiency syndrome (AIDS) and a pulmonary non-Hodgkin lymphoma treated with zidovudine and no other treatment is presented. Results. The patient achieved a prolonged partial remission of a pulmonary non-Hodgkin lymphoma while receiving zidovudine alone. Conclusions. Zidovudine may have antitumor effects in Aids-related lymphomas and should be evaluated for its antitumor potential. Cancer 1993; 71:2332-4.