This trial was designed to improve the long-term survival of pts. with AIL. The study has evolved from an observation made within the NIH (NCI and NIAID) that pts. with Grade III AIL (or angiocentric lymphoma), who were treated with aggressive combination chemotherapy had a higher response rate and improved survival compared to pts. with Grades I or II AIL treated with low-dose alkylating agents and/or prednisone. Half of the pts. on low-dose chronic therapy eventually developed lymphomas refractory to treatment and most eventually succumbed to their disease. Thus pts. initially diagnosed with overt lymphoma enjoyed a greater long-term survival than pts. with diseases (grades I and II AIL) traditionally felt to be premalignant or benign inflammatory conditions. This study is intended to determine if all pts. with AIL will benefit from initial intensive combination chemotherapy. 14 pts. have been entered on study. 11 of 14 pts. (79%) have achieved a complete remission. 3 pts. have relapsed (27%); 2 of the 3 relapsers have undergone ABMT and are in durable 2nd remissions. One induction failure received radiation and is in durable remission. Four pts. (29%) have died; 2 induction failures; 1 relapsed pt. who developed a second malignancy and 1 pt. who developed a glioblastoma multiforme while in CR and died from his brain tumor. Larger pt. numbers and longer follow-up are necessary to draw from conclusions.
