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The Treatment of AIDS-Related Lymphoma-Reply

Alexandra M. Levine, MD
JAMA. 1992;267(4):510. doi:10.1001/jama.1992.03480040057025.
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In Reply.  —Unfortunately, Tirelli et al are incorrect in their first assumption that "patients with poor prognosis, ie, those with low performance status and presence of OIs, were not eligible for entry into this study." This is not true. Several retrospective and prospective series have confirmed those factors that are considered to be of poor prognostic impact in the patient with AIDS lymphoma.1,2 These include history of prior AIDS, CD4 cell counts less than 200 × 106/L as a continuous variable, Karnofsky performance status of 70% or less, and stage IV disease, especially with bone marrow involvement. None of these factors served to exclude patients from our study, which allowed patients with Kaposi's sarcoma as low as 50% (defined as the patient who is unable to work, and requires considerable assistance and frequent medical care), any CD4 cell count, any history of AIDS or 01, and


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