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HIV and Follicular NHL

May 10, 2008

My brother is 37 HIV positive now for 12yrs. He survived 3 1/2 years ago stage IV Hodgkins Disease after agressive ABVD chemotherapy. He has now been diagnosed with tumors in his mediastinum, Iliac, he has one pressing on his trachea and also has some on his scalp. from his last biopsy he had immunostains of CD15,CD20,CD30. His oncologist is up in the air because he is currently not as sick as he was with the Hodgkins. He has abdominal pain, lost 8lbs and has some fatigue. His HIV status is cd4 count in the 600's viral load undetectable not sure his percentage. They want to do another biopsy in his Iliac area due to last biopsy was ruined when going back to try and use again. They are questioning Follicular NHL which they said is slower growing where some of his tumors are already 8cm plus and he has one that is nacrotic in ths middle. From what I read is it true that it is rare to have a indolent Form of NHL when HIV is present? Also where he is relapsed from hodgkins disease does this complicate treatment and a positive prognosis? I believe the reason he is not as sick as before for one he is nolonger on AZT which wasn't kosher for him. Had way to many side effects and two they caught it early on a routine scan. His oncologists are saying if it is follicular NHL there is no treatment and no cure. so what I ask of you is to shead any light on this situation and any information would be great.

Thanks for your time a very concerned sister.


Response from Dr. Frascino

Hello Cheryl,

It would be difficult for me to shed any additional light on your brother's situation without first knowing the exact diagnosis (results of second biopsy). Certainly the prognosis of follicular Non-Hodgkin's lymphoma is different from Hodgkin's lymphoma. Once the biopsy results are back, if you and your brother remain confused or concerned about treatment options, getting a second opinion from another AIDS oncologist (perhaps at a major medical research center) would be in order. My brother was diagnosed with stage IV lung and brain cancer several years ago and given a prognosis of six months maximum. By getting creative with treatments, he beat the odds and lived over two years. During that time we traveled the world together and he had time to get his affairs in order. I'm sure this is a very frightening time for both your brother and you. Don't lose hope.

Good luck to you both.

Dr. Bob

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