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Treatment with etoposide, prednisone, Oncovin (vincristine), cyclophosphamide, and hydroxydaunorubicin (doxorubicin) (EPOCH) has produced responses of 79% in a preliminary study.
High tumor proliferation determined by Ki-67 or MIB-1 immunohistochemistry has been shown to be an adverse prognostic finding with CHOP chemotherapy, suggesting “kinetic failure” is a problem.
Malignant cells can only be found in body cavities (e.g., pleural, pericardial, peritoneal), showing a non-B-, non-T phenotype.
There is a close association with HHV-8, which can be detected in malignant cells.
These regimens, given for several days as infusions, are supposed to overcome the potential chemotherapy resistance of lymphoma cells.
In the case of CD20-positive B-cell lymphoma, it is not clear whether the monoclonal CD20 antibody rituximab has a similarly large clinical benefit for HIV-infected patients as it has for HIV-negative patients.