To the Editor.
—Levine et al1 have recently reported in JAMA that low-dose chemotherapy with central nervous system (CNS) prophylaxis and zidovudine maintenance did not compromise the therapeutic outcome of 42 patients with non-Hodgkin's lymphoma (NHL) related to the acquired immunodeficiency syndrome (AIDS). However, patients with poor prognosis, ie, those with low performance status and presence of opportunistic infections (OIs), were not eligible for entry into this study.We in the French-Italian Cooperative Study Group have recently performed a prospective study in patients with poor-prognosis AIDS-related NHL, defined as those with performance status greater than 3 and/or presence of OIs. We used a low-dose chemotherapeutic regimen with CNS prophylaxis in combination with antiretroviral therapy, the aim being to reduce both the toxic effects on the bone marrow and the occurrence of OIs. The chemotherapeutic regimen employed was that used by the European Organization on Research and Treatment of
Tirelli U, Errante D, Oksenhendler E, Vaccher E, Gastaldi R, Rizzardini G, Monfardini S, Gisselbrecht C. The Treatment of AIDS-Related Lymphoma. JAMA. 1992;267(4):509. doi:10.1001/jama.1992.03480040057024