Non-Hodgkin's lymphoma (NHL) remains the second most common malignant complication in patients with human immunodeficiency virus (
HIV) infection. Even though NHL is commonly chemosensitive to primary treatment, failure or relapse still occurs in a large number of patients. We conducted this retrospective study to evaluate the efficacy and safety of
gemcitabine,
dexamethasone, and
cisplatin (
GDP) for relapsed or refractory
AIDS-related NHL (
AIDS-NHL). Forty-eight patients with relapsed or refractory
AIDS-NHL were treated with intravenous
combination chemotherapy with
GDP. The overall objective response rate was 54.1% (95% confidence interval, CI, 40.1-68.3%), with 10 complete responses and 16 partial responses. The 2-year overall survival rate (OS) was 70.8% (95% CI 58.0-83.7%), and the 5-year OS was 41.7% (95% CI 27.7-55.6%). The 2-year progression-free survival rate (PFS) was 37.5% (95% CI 23.8-51.2%), and the 5-year PFS was 25.0% (95% CI 12.8-37.3%). The median progression-free survival was 8.8 months (95% CI 0-20.3 months), and the median overall survival was 40.6 months (95% CI 22.6-58.6 months). Patients with B cell
tumors who relapsed but had no B symptoms were clinical stage I/II, had infiltration fewer than two extranodal sites, had CD4⁺ counts >200 cells/μL, and had
lactate dehydrogenase (LDH) less than the upper limit of normal benefited from
GDP. The level of LDH had a significant impact on the response rate to
chemotherapy with
GDP (P = 0.015). Myelosuppression was the main side effect; the incidence of grade 3-4
anemia was 8.3%;
leukopenia, 37.5%; and
thrombocytopenia, 48.3%. Univariate and multivariate analyses were performed to determine variables for OS and PFS. This study confirms that
GDP is an effective and safe salvage regimen in relapsed or refractory
AIDS-NHL, was associated with modest declines in CD4⁺ lymphocyte counts, and did not promote HIV-1 viral replication.