Background. The outcome of HIV-associated
non-Hodgkin lymphoma (NHL) has improved substantially in the
highly active antiretroviral therapy (
HAART) era. However, HIV-
Burkitt lymphoma (BL), which accounts for up to 20% of HIV-NHL, has poor outcome with standard
chemotherapy. Patients and Methods. We retrospectively reviewed HIV-BL treated in the
HAART era with the Magrath regimen (CODOX-M/IVAC±R) at four Canadian centres. Results. Fourteen patients with HIV-BL received at least one CODOX-M/IVAC±R treatment. Median age at BL diagnosis was 45.5 years, CD4 count 375 cells/mL and HIV viral load (VL) <50 copies/mL. Patients received PCP prophylaxis and
G-CSF, 13 received
HAART with
chemotherapy and 10
rituximab. There were 63 episodes of toxicity, none fatal, including:
bacterial infection, n = 20; grade 3-4 hematologic toxicity, n = 14;
febrile neutropenia, n = 7; oral
thrush; and
ifosfamide neurological toxicity, n = 1 each. At a median followup of 11.7 months, 12 (86%) patients are alive and in remission. All 10 patients who received
HAART,
chemotherapy, and
rituximab are alive. CD4 counts and HIV VL 6 months following BL
therapy completion (n = 5 patients) were >250 cells/mL and undetectable, respectively, in 4. Conclusion. Intensive
chemotherapy with CODOX-M/IVAC±R yielded acceptable toxicity and good survival rates in patients with HIV-associated
Burkitt lymphoma receiving
HAART.