Important note: Information in this article was accurate in 1991. The state of the art may have changed since the publication date.
TREATMENT OF AIDS-RELATED LYMPHOMA WITH A TWELVE-WEEK CHEMOTHERAPY PROGRAM (MEETING ABSTRACT)
Proc Annu Meet Am Soc Clin Oncol; 10:A3 1991. Unique Identifier : AIDSLINE ICDB/91671336 Sawka C; Shepherd F; Toronto-Bayview Regional Cancer Centre, Toronto, Canada
Abstract:
Conventional chemotherapy programs are poorly tolerated and only moderately effective in AIDS-lymphoma (NHL). This protocol attempts to improve patient (pt) tolerance, reduce opportunistic infections (OI) and decrease the development of CNS NHL. The 12 wk program is as follows: Adriamycin 25 mg/m2 iv wk 1, 5, 9; VP-16 75 mg/m2 iv day 1, 150 mg/m2 po day 2 wk 1, 3, 5, 7, 9, 11; cyclophosphamide 300 mg/m2 iv wk 3, 7, 11; prednisone 100 mg od x 4 days wk 1, 5, 9; methotrexate 400 mg/m2 iv with leucovorin 50 mg po x 6 doses wk 2, 6, 10; vincristine 1 mg/m2 iv wk 2, 4, 6, 8, 10, 12; bleomycin 4 mg/m2 iv wk 4, 8, 12. Intrathecal ara-c 50 mg was given on even weeks for 6 doses; radiation was given only to bulky sites of CNS disease. Aerosolized pentamidine was given for the duration of therapy and AZT was given after chemotherapy was completed. Twenty male pts (median age 38 yr) have been entered; 18 are evaluable (2 too early) with a median follow-up of 24 wk. Pathology was diffuse large cell in 7, immunoblastic in 7, small noncleaved in 3 and unclassified in 1. 12/18 were Stage 4, and 4 had localized extranodal disease. Sites included liver (4), GI (6), bone marrow (2), CSF (1). Ten had B symptoms. Complete remission occurred in 9 (50%) and partial remission in 6 (33%). Eight responders have relapsed. The median time to progression is 28 wk. Actuarial median survival is 35 wk from diagnosis. Febrile neutropenia was seen in 10 but was never fatal. No pt developed PCP on or after therapy. Four other OI developed, but OI was responsible for death in only 1 case (cryptococcal meningitis). Other serious toxicity was not seen. CNS lymphoma did not develop in any pt during therapy. In conclusion: (1) this 12 wk regimen produces neutropenia but it has efficacy in AIDS-lymphoma, (2) biweekly intrathecal Ara-C appeared to prevent CSF NHL, (3) no cases of PCP were seen and other OI were uncommon. Recurrent NHL remains a major challenge, however, and further studies are needed.
Keywords: Acquired Immunodeficiency Syndrome/COMPLICATIONS/*DRUG THERAPY Adult Antineoplastic Agents, Combined/*THERAPEUTIC USE Combined Modality Therapy Drug Administration Schedule Human Lymphoma, Non-Hodgkin's/COMPLICATIONS/*DRUG THERAPY Male Zidovudine/THERAPEUTIC USE ABSTRACT
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Important note: Information in this article was accurate in 1991. The state of the art may have changed since the publication date.
