Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.
407 patients (pts) with AIDS-related non-Hodgkin's lymphoma (AIDS-NHL): the experience of the GICAT (Italian Cooperative Group on AIDS and Tumors) with emphasis on the prospective treatment of 93 pts at a single institution (Meeting abstract).
Proc Annu Meet Am Soc Clin Oncol; 13:A21 1994. Unique Identifier : AIDSLINE ICDB/94600018 Tirelli U; Spina M; Vaccher E; Carbone A; Serraino D; GICAT, C.R.O Aviano, Italy
Abstract:
Since November 1986, we have collected data on 407 pts with peripheral AIDS-NHL observed in several Italian institutions of the GICAT. 62% of pts were intravenous drug users (IVDUs) in accordance to the overall epidemiology of HIV infection in Italy, 83% were males, the median age was 30 years. At diagnosis of AIDS-NHL CD4 less than 100 mm/mm3 were detected in 46% of the pts, and opportunistic infections (OIs, Cl according to CDC) preceded or accompanied the NHL in 41% of the pts. Immunoblastic and Burkitt were diagnosed in 58% and 20% of the pts, respectively; advanced (III and IV) stage and B symptoms were present in 80% and 69% of the pts, respectively. Median survival of the overall population was 6 mo, by the Cox model four factors were associated with a significantly shorter survival: advanced stage, heterosexuality, no treatment received and not having obtained a CR. At the Aviano Cancer Center, in the same period of time 93 of these pts have been treated according to prospective protocols. Based on HIV-related prognostic factors, pts with unfavorable histology and stage III and IV were treated with intensive third generation chemotherapy regimens (group 1, usually with CD4 greater than 200, good PS and without OI), with palliative chemotherapy with just 1 or 2 drugs or local RT (group 3, usually with CD4 less than 100, poor PS and with OI) or with standard CHOP-like chemotherapy regimens (group 2, the remaining pts). A table reports the parameters that reached statistical significance in the comparison between the 3 groups of evaluable pts. A significantly higher CR rate has been observed in group 1 pts, but with a concomitant increase of OIs during CT and follow-up, in comparison to group 2 pts. However group 1 pts had a 15 decreased risk of dying in comparison to group 2 and 3. Overall, 13 pts with a CR lasting for at least 2 years had a 42-month median survival with none of such pts relapsing even after 6 years. In conclusion, we have observed a large number of peripheral AIDS-NHL mainly with immunoblastic and Burkitt subtypes, advanced stage and B symptoms. In the prospective treatment at a single institution, intensive chemotherapy regimens were associated both to higher CR rate and higher OIs during CT and follow up, with some pts experiencing long survival and possibly cure. The potential role of bone marrow growth factors in order to decrease bone marrow toxicity and more efficacious OI prophylactic therapy are currently prospectively tested.
Keywords: Adult Antineoplastic Agents, Combined/ADVERSE EFFECTS/*THERAPEUTIC USE Combined Modality Therapy Female Follow-Up Studies Human Italy Lymphoma, AIDS-Related/*DRUG THERAPY/MORTALITY/RADIOTHERAPY Male Palliative Care Prospective Studies Survival Rate ABSTRACT 940830
M9480773
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Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.
