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Possible Lymphoma? Is it possible to remain lymphoma free once one is in remission?
Apr 4, 2002

I am very worried for my partner of 20 years. He is 43 years old now. I brought him to the hospital with very high fever and a headache -- no other symptoms. In the emergency room they isolated him immediately with suspicion of meningitis; the spinal tap test was negative to our relief. That same day the doctors thought he might have pneumonia after seeing the x-rays but with no certain diagnosis -- that was yesterday. Today one of the doctors mentioned possible lymphoma. This really made me very nervous. This evening they performed a CT-scan of the head, chest and abdomen. The fever remains very high for 2 days now and his head is near bursting. He was diagnosed and treated in Switzerland in 1994 with Non Hodgkin's Lymphoma -- (CD4 about 100). He had tumors in his mouth. After the first cycle of 6 with CHOP chemotherapy, his tumors disappeared and he has remained free of cancer ever since. Is this a possible diagnosis at this present time? He had no weight loss, night sweats or any other typical lymphoma symptoms. His present CD4 count is 800 and viral load- undetectable. If it turns out to be lymphoma is it more difficult to treat the second time around? About 4 weeks ago he was in the same hospital for one week with divertculitis. He was successfully treated with antibiotics. I thought with such a high CD4 count he should remain somewhat free of all these infections. Is it possible to remain lymphoma free for good once one is in remission? Thank you very much for your time answering this question. Worried in NY

Response from Dr. Dezube

If your partner's lymphoma was in 1994, it would be most extraordinary for that same lymphoma to come back after 8 years! However, he, as well as any HIV-infected patient, can develop a totally new HIV-related lymphoma. If he were to develop a totally new lymphoma, then chances are good that it would be as treatable as the initial lymphoma. In fact, his chances may even be better given that his CD4 count is 800. You mention that he had a CT scan of the head, chest and abdomen, but you don't give the results of it. Did they show anything? Hopefully his symptoms will go away by themselves. If not, he will need further evaluation. Such an evaluation could potentially include a bone marrow examination, a gallium scan, more blood work, and so on. Please let me know if he ends up having lymphoma or other HIV-related cancer. And yes, it is possible to remain lymphoma free for good once one is in remission. BD.

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