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Primary Central Nervous System Lymphoma (PCNSL)
Jan 5, 1998

Dear Dr. Gallant,

I'm HIV+ diagnosed in July 95, at this time I was also stricken with high-grade Non-Hodgskin's Lymphoma. I received three CHOP chemotherapy (as well as lumbar puncture) and responded very well to the treatment. The prognosis at that time was not good... 8 months with chemo and 2 months without. I am currently on cocktail (AZT/3TC/Crix); CD4 over 900, VL undetectable. Recently, I came across an article about a brain cancer called PCNSL. The article wasn't thoroughly written and raised some questions in my mind. Given my lymphoma history am I predisposed to this type of cancer? What are the symptoms? I am currently on remission as regards to my lymphoma, what is the likelihood that my lymphoma would come back and approximately how long after initial diagnosis? I would appreciate your reply...thanks very much. HF

Response from Dr. Gallant

Primary CNS lymphoma (PCNSL) is not really related to the kind of lymphoma you had. Unlike systemic lymphoma, which can occur at virtually any stage of HIV disease, PCNSL requires advanced HIV infection (usually the CD4 count is under 50). It has a much poorer prognosis, in part because people tend to be sicker when they get it, and it tends to be treated with radiation rather than chemotherapy.

There is no reason to think that you'd be at any greater risk of developing PCNSL because of your lymphoma history.


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