A pilot trial of infusional cyclophosphamide, doxorubicin and etoposide (CDE) plus didanosine (DDI) in HIV-related non-Hodgkin's lymphoma (NHL) (Meeting abstract).

Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.

A pilot trial of infusional cyclophosphamide, doxorubicin and etoposide (CDE) plus didanosine (DDI) in HIV-related non-Hodgkin's lymphoma (NHL) (Meeting abstract).

Proc Annu Meet Am Soc Clin Oncol; 13:A7 1994. Unique Identifier : AIDSLINE ICDB/94600004
Sparano JA; Wiernik PH; Dutcher JP; Sarta C; Leaf A; Hu XP; Albert Einstein Cancer Center, Montefiore Medical Center, Bronx,; NY 10467

Abstract: We reported a 75% complete response (CR) rate and 18 mo median survival for 16 patients (pts) with HIV-related NHL treated with infusional CDE (Blood 81:2810, 1993; Proc ASCO 12:51, 1993), but observed substantial hematopoietic toxicity and decreased CD4+ lymphocytes (111/ul +/- 23 pre vs 52 +/- 12 post 2 cycles, P = 0.04). Since DDI ameliorates HIV-related cytopenias (Blood 80:2969, 1992), we initiated a pilot trial to evaluate the feasibility of combining DDI (200 mg po bid, cycles 1,2,5,6 or cycles 3,4,5,6) with infusional CDE. Granulocyte-colony stimulating factor (5 ug/kg/day) was given day 5-recovery. Pt characteristics: N=9; prior antivirals (N=6); median CD4 count (120/ul); histology J (N=4), H (N=3), G (N=2); stage IV (N=8), II (N=1); median LDH 230 IU/L. CR occurred in 4/7 evaluable pts, and 1 pt still receiving therapy has a near CR. The nadir leukocyte count (WBC), absolute neutrophil count (ANC), and platelet count were compared for cycles in which DDI was (N=10) or was not (N=10) given for 5 pts who completed at least 3 cycles. Data are shown in a table. The mean decrease in the CD4 count was 29/ul (+/- 54) for pts treated with CDE plus DDI compared with 61/ul +/- for our prior group treated with CDE alone (P=0.6). Conclusions: (1) Infusional CDE plus DDI is tolerable and active. (2) Our preliminary data suggest a protective effect for DDI against hematopoietic toxicity and CD4 lymphopenia, but the differences noted to date are not significant. Further study is warranted in order to confirm our preliminary findings.

Keywords: Antineoplastic Agents, Combined/ADVERSE EFFECTS/*THERAPEUTIC USE Cyclophosphamide/ADMINISTRATION & DOSAGE/ADVERSE EFFECTS Didanosine/ADMINISTRATION & DOSAGE/ADVERSE EFFECTS Dose-Response Relationship, Drug Doxorubicin/ADMINISTRATION & DOSAGE/ADVERSE EFFECTS Etoposide/ADMINISTRATION & DOSAGE/ADVERSE EFFECTS Feasibility Studies Granulocyte Colony-Stimulating Factor/ADMINISTRATION & DOSAGE Human HIV Infections/*DRUG THERAPY Infusions, Intravenous Leukocyte Count/DRUG EFFECTS Lymphoma, AIDS-Related/*DRUG THERAPY Pilot Projects ABSTRACT
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