PROSPECTIVE STUDY WITH COMBINED LOW-DOSE CHEMOTHERAPY AND ZIDOVUDINE FOR 37 PATIENTS (PTS) WITH POOR PROGNOSIS HIV-RELATED NON-HODGKIN'S LYMPHOMA (HIV-NHL) (MEETING ABSTRACT) NLM AIDSLINE Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.

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PROSPECTIVE STUDY WITH COMBINED LOW-DOSE CHEMOTHERAPY AND ZIDOVUDINE FOR 37 PATIENTS (PTS) WITH POOR PROGNOSIS HIV-RELATED NON-HODGKIN'S LYMPHOMA (HIV-NHL) (MEETING ABSTRACT)

Proc Annu Meet Am Soc Clin Oncol; 11:A3 1992. Unique Identifier : AIDSLINE ICDB/92680734
Errante D; Tirelli U; Oksenhendler E; Vaccher E; Gastaldi R; Rizzardini G; Accurso V; Spina M; Monfardini S; Gisselbrecht C; Centro di Riferimento, Oncologico, Aviano, Italy

Abstract: Since May 1988, within the French-Italian Cooperative Study Group, 37 consecutive pts with HIV-NHL and poor prognosis, ie, with PS greater than or equal to 3 and/or opportunistic infections (OI) in their history were prospectively treated with combined low-dose chemotherapy CHVmP vincristine bleo (50% reduced dosage): cyclophosphamide 300 mg/m2 iv day 1, doxorubicin 25 mg/m2 iv day 1, teniposide 30 mg/m2 iv day 1, prednisone 20 mg/m2 per os days 1-5, vincristine 2 mg iv day 15 and bleomycin 10 mg iv day 15 (every 3 wk for 8 cycles) and zidovudine (AZT) at the dosage of 500 mg/day per os. 30 pts were males and 7 females, 19 were iv drug users, 6 homosexual men; asymptomatic HIV was present in 15 pts, ARC in 10 pts and AIDS in 12 pts. The CD4+/CD8+ ratio was less than 1 in all pts with absolute CD4+ mean count of 35/mm3. Of the 37 pts, only 29 are evaluable for response. Eight are not evaluable in that they received only one cycle of chemotherapy. Of these pts, 2 died because of treatment toxicity, 4 died because of OI and 2 were lost to follow-up. Overall, 15 out of 29 (52%) evaluable pts obtained an objective response but only 4 (14%) achieved a CR with 1, 4, 14 and 29+ mo duration. Fourteen (48%) pts had NR. The median duration of the 11 PRs was 4 mo and only 2 pts of this group are alive at the time of the evaluation. Of these pts, 4 died of OI, 3 because of NHL progression and 2 of both causes. As far as toxicity, the most common side effect was bone marrow suppression. In 18 pts, grade IV leukopenia (fatal in 1 pt) and in 5 pts grade IV thrombocytopenia (fatal in 1 pt) were observed. Twenty-one out of 37 pts received AZT for a median duration of 20 mo (range 1-8). Thirteen pts did not receive AZT as scheduled due to the fact that they had granulocytopenia at the diagnosis of HIV-NHL, while 3 pts refused the drug. In these 16 pts, we observed 5 (31%) OI. Out of the 21 pts who actually received AZT treatment, only 12 (57%) were able to receive the drug during the entire time of chemotherapy as scheduled, while the other 9 pts had to stop the treatment due to hematological toxicity. In this group of pts, we observed 9 (45%) OI. The median survival of all pts is 3.5 mo, without statistically significant differences between pts who did and did not obtain CR. In conclusion, our study indicates that pts with poor prognosis HIV-NHL did not benefit from a combined low-dose chemotherapy and AZT.
Keywords: Acquired Immunodeficiency Syndrome/*COMPLICATIONS/*DRUG THERAPY Antineoplastic Agents, Combined/*THERAPEUTIC USE AIDS-Related Complex/*COMPLICATIONS/*DRUG THERAPY Bleomycin/ADMINISTRATION & DOSAGE Cyclophosphamide/ADMINISTRATION & DOSAGE Doxorubicin/ADMINISTRATION & DOSAGE Drug Administration Schedule Female Homosexuality Human HIV Infections/*COMPLICATIONS/*DRUG THERAPY Lymphoma, Non-Hodgkin's/*DRUG THERAPY/*ETIOLOGY Male Prednisone/ADMINISTRATION & DOSAGE Prospective Studies Teniposide/ADMINISTRATION & DOSAGE Vincristine/ADMINISTRATION & DOSAGE Zidovudine/ADMINISTRATION & DOSAGE/*THERAPEUTIC USE CLINICAL TRIAL ABSTRACT

KWDacquiredimmunodeficiencysyndrome/KWDcomplications/KWDdrugtherapyantineoplasticagents,combined/KWDtherapeuticuseaids-relatedcomplex/KWDcomplications/KWDdrugtherapybleomycin/administration&dosagecyclophosphamide/administration&dosagedoxorubicin/administration&dosagedrugadministrationschedulefemalehomosexualityhumanhivinfections/KWDcomplications/KWDdrugtherapylymphoma,non-hodgkin's/KWDdrugtherapy/KWDetiologymaleprednisone/administration&dosageprospectivestudiesteniposide/administration&dosagevincristine/administration&dosagezidovudine/administration&dosage/KWDtherapeuticuseclinicaltrialabstract
921130
M92B0905

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