Chemotherapy In HIV Associated Systemic Lymphoma With CNS Involvement- Experience With A Case

Abstract

We report the case of a 49 year old health worker, HIV positive, who presented with a 2 months history of a rapidly enlarging cervical lymphadenopathy, right breast lump, hearing loss and weight loss. Disease progressed to a right facial nerve palsy, upper motor neurone type with right hemiparesis. CD 4 count was at 80/mm3 and Brain CT showed a left temporal lobe mass. She had a reversal of neurologic deficit within 72 hours with administration of doxorubicin. She continued cyclical chemotherapy with doxorubicin, vincristine , cyclophosphamide and later etoposide with intrathecal methotrexate, making a full recovery with complete resolution of the temporal lobe mass and neurologic symptoms. Granulocyte colony stimulating factor support, repeated blood transfusion and substitution of zidovudine containing HAART emerged effective strategies in achieving success.