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Additional cure needed? a survivor of Burkitt's lymphoma
Aug 29, 2002

Dear Dr.Dezube, I am a 39 year old survivor of Burkitt lymphoma with a very aggressive chemotherapy (CODOX-M/Ara-C). In facts,I had only the first part of 4 parts and stopped the cure because of liver and kidney problems but fortunately got into remission 6 months ago. My HIV viral load is under 50 and CD4>350-400. I think I am very lucky. Do you think that I must have another additional cure to avoid relapse of the lymphoma?

Response from Dr. Dezube

If I understand your query correctly, it sounds like you got just 25% of your chemotherapy? Is this true? Try to figure out from your oncologist exactly what percent of the originally planned chemotherapy you received. It is not unusual for patients not to finish all planned treatments because of side effects, infections, and so on. If you received 80% or more of the planned doses than you are probably all set and all you need to do is stay on your HIV medications. That's your best assurance that the lymphoma won't come back. If you received substantially less chemotherapy, then you are indeed at risk of having the lymphoma return. Do you know if your tumor cells stain for a chemical called CD20 (most lymphomas contain this). If your tumor cells stain for CD20 (your oncologist will have this information), then he could treat you with an antibody to CD20. This antibody is relatively non-toxic, when compared to chemotherapy, and can give you some extra protection against your lymphoma. That's probably what I would do if you were to be my patient.

KS and Acyclovir
KS, Chemotherapy and CD4-Cells; How much of a hit will my CD4 cells take if I start chemotherapy?

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