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January 6, 1993, Vol 269, No. 1 >
ARTICLE | January 6, 1993

AIDS-Associated Primary Central Nervous System Lymphoma FREE

Giorgio Galetto, MD; Alexandar Levine, MD
[+] Author Affiliations

Reprint requests to University of Southern California School of Medicine, 1441 Eastlake Ave, Los Angeles, CA 90033 (Dr Levine).


JAMA. 1993;269(1):92-93. doi:10.1001/jama.1993.03500010102041
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References

A CLINICAL and scientific impasse in the area of primary central nervous system (P-CNS) lymphoma related to the acquired immunodeficiency syndrome (AIDS) has provoked this commentary from the Oncology Committee of the AIDS Clinical Trials Group (ACTG), a national cooperative group for the treatment of human immunodeficiency virus (HIV) infection and its associated illnesses. We believe that progress in this area has been impeded because of two unwarranted assumptions: first, the fear of contagion, which has prevented some neurosurgeons from obtaining biopsy specimens from HIV-infected patients with intracerebral mass lesions1; and second, the belief that treatment would be ineffective, which has prevented many primary practitioners from referring such patients, and many oncologists from treating them, even in the setting of prospective protocols. These attitudes have impeded attempts to obtain primary tissues from which to make appropriate diagnoses, or to develop improved therapeutic strategies, serving to fulfill existing negative expectations.

REFERENCES

1 +
Corn BW, Trock BD.  Impact of medical specialty on the approach to AIDS patients with intracranial mass lesions. Proc ASCO . 1992;;11:44. Abstract.
2 +
Henderson DK, Fahey BJ, Willy M, et al.  Risk for occupational transmission of human immunodeficiency virus type 1 (HIV-1) associated with clinical exposures: a prospective evaluation. Ann Intern Med . 1990;;113:740-746.
3 +
Marcus R, CDC  Cooperative Needlestick Study Group. Surveillance of health care workers exposed to blood from patients infected with the human immunodeficiency virus. N Engl J Med . 1988;;319:1118-1123.
4 +
Gerberding JL, Bryant-LeBlanc CE, Nelson K, et al.  Risk of transmitting the human immunodeficiency virus, cytomegalovirus and hepatitis B virus to health care workers exposed to patients with AIDS and AIDS related conditions. J Infect Dis . 1987;;156:1-8.
5 +
Levy RM, Russell E, Yungbluth M, et al.  The efficacy of image-guided stereotactic brain biopsy in neurologically symptomatic acquired immunodeficiency syndrome patients. Neurosurgery . 1992;;30:186-190.
6 +
Shetter AG, Bertuccini AV, Pittman HW.  Closed needle biopsy in the diagnosis of intracranial mass lesions. Surg Neurol . 1977;;8:341-345.
7 +
Baumgartner JE, Rachlin JR, Beckstead JH, et al.  Primary central nervous system lymphomas: natural history and response to radiation therapy in 55 patients with acquired immunodeficiency syndrome. J Neurosurg . 1990;;73:206-211.
8 +
Formenti SC, Gill PS, Lean E, et al.  Primary central nervous system lymphoma in AIDS: results of radiation therapy. Cancer . 1989;;63:1101-1107.
9 +
Socie G, Pipro-Chauffat C, Schlienger M, et al.  Primary lymphoma of the central nervous system: an unresolved therapeutic problem. Cancer . 1990;;65:322-326.
10 +
DeAngelis LM, Yahalom J, Heinemann M-H, Cirrincione C, Thaler HT, Krol G.  Primary central nervous system lymphoma: combined treatment with chemotherapy and radiotherapy. Neurology . 1990;;40:80-86.
11 +
Levine AM, Wernz JC, Kaplan L, et al.  Low-dose chemotherapy with central nervous system prophylaxis and zidovudine maintenance in AIDS-related lymphoma: a prospective multi-institutional trial. JAMA . 1991;;266:84-88.
12 +
Eby NL, Grufferman S, Flannelly CM, Scholf SC, Vogel FS, Burger PC.  Increasing incidence of primary brain lymphoma in the U.S. Cancer . 1988;;62:2461-2465.
13 +
Gail MH, Pluda JM, Rabkin CS, et al.  Projections of the incidence of non-Hodgkin's lymphoma related to the acquired immunodeficiency syndrome. J Natl Cancer Inst . 1991;;83:695-701.
14 +
Pluda JM, Yarchoan R, Jaffe ES, et al.  Development of non-Hodgkin's lymphoma in a cohort of patients with severe human immunodeficiency virus infection on long-term antiretroviral therapy. Ann Intern Med . 1990;;113:276-282.

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1 +
Corn BW, Trock BD.  Impact of medical specialty on the approach to AIDS patients with intracranial mass lesions. Proc ASCO . 1992;;11:44. Abstract.
2 +
Henderson DK, Fahey BJ, Willy M, et al.  Risk for occupational transmission of human immunodeficiency virus type 1 (HIV-1) associated with clinical exposures: a prospective evaluation. Ann Intern Med . 1990;;113:740-746.
3 +
Marcus R, CDC  Cooperative Needlestick Study Group. Surveillance of health care workers exposed to blood from patients infected with the human immunodeficiency virus. N Engl J Med . 1988;;319:1118-1123.
4 +
Gerberding JL, Bryant-LeBlanc CE, Nelson K, et al.  Risk of transmitting the human immunodeficiency virus, cytomegalovirus and hepatitis B virus to health care workers exposed to patients with AIDS and AIDS related conditions. J Infect Dis . 1987;;156:1-8.
5 +
Levy RM, Russell E, Yungbluth M, et al.  The efficacy of image-guided stereotactic brain biopsy in neurologically symptomatic acquired immunodeficiency syndrome patients. Neurosurgery . 1992;;30:186-190.
6 +
Shetter AG, Bertuccini AV, Pittman HW.  Closed needle biopsy in the diagnosis of intracranial mass lesions. Surg Neurol . 1977;;8:341-345.
7 +
Baumgartner JE, Rachlin JR, Beckstead JH, et al.  Primary central nervous system lymphomas: natural history and response to radiation therapy in 55 patients with acquired immunodeficiency syndrome. J Neurosurg . 1990;;73:206-211.
8 +
Formenti SC, Gill PS, Lean E, et al.  Primary central nervous system lymphoma in AIDS: results of radiation therapy. Cancer . 1989;;63:1101-1107.
9 +
Socie G, Pipro-Chauffat C, Schlienger M, et al.  Primary lymphoma of the central nervous system: an unresolved therapeutic problem. Cancer . 1990;;65:322-326.
10 +
DeAngelis LM, Yahalom J, Heinemann M-H, Cirrincione C, Thaler HT, Krol G.  Primary central nervous system lymphoma: combined treatment with chemotherapy and radiotherapy. Neurology . 1990;;40:80-86.
11 +
Levine AM, Wernz JC, Kaplan L, et al.  Low-dose chemotherapy with central nervous system prophylaxis and zidovudine maintenance in AIDS-related lymphoma: a prospective multi-institutional trial. JAMA . 1991;;266:84-88.
12 +
Eby NL, Grufferman S, Flannelly CM, Scholf SC, Vogel FS, Burger PC.  Increasing incidence of primary brain lymphoma in the U.S. Cancer . 1988;;62:2461-2465.
13 +
Gail MH, Pluda JM, Rabkin CS, et al.  Projections of the incidence of non-Hodgkin's lymphoma related to the acquired immunodeficiency syndrome. J Natl Cancer Inst . 1991;;83:695-701.
14 +
Pluda JM, Yarchoan R, Jaffe ES, et al.  Development of non-Hodgkin's lymphoma in a cohort of patients with severe human immunodeficiency virus infection on long-term antiretroviral therapy. Ann Intern Med . 1990;;113:276-282.

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