Important note: Information in this article was accurate in 1995. The state of the art may have changed since the publication date.
Treatment of AIDS-related non-Hodgkin lymphoma with polychemotherapy, DDI and GM-CSF (Meeting abstract).
Proc Annu Meet Am Assoc Cancer Res; 14:A832 1995. Unique Identifier : AIDSLINE ICDB/95613984 Schmilovich A; Perez H; Cahn P; Grinberg N; Casiro A; Gil Deza E; Fundacion Huesped, Hospital Ferrnandez, ARCOS 2626, 1428,; Argentina
Abstract:
The objective of this pilot protocol is to evaluate the efficacy and toxicity of combining chemotherapy with DDI and GM-CSF for the treatment of AIDS related NHL. HIV seropositive patients (pts) with untreated intermediate or high grade systemic NHL were enrolled. Pts had ECOG PS less than or equal to 2 with no active opportunistic infection or visceral Kaposi's Sarcoma. Chemotherapy consisted of 21 day cycles: day 1 cyclophosphamide 600 mg/m2 (C), doxorubicin 15 mg/m2 (A), VP16 100 mg/m2 iv (E), day 2-3 VP16 200 mg/m2 orally (day 1-8), bleomycin 5 V/m2 day 8 (B). Intrathecal methotrexate 12 mg weekly X 4 in CSF (-) or weekly until CSF becomes negative. DDI (500 mg/day) was administered daily and GM-CSF (5 mg/kg/day SC) was given on days 6-20. C, A and E were escalated by 10% in cycle 3 or later when previous cycles had resulted in absolute neutrophil nadirs of greater than or equal to 1000 cells/m3 . All pts received trimethoprim-sulfamethoxazole (TMS) prophylaxis. 14 pts have been enrolled. 6 pts were asymptomatic HIV-positive, 10 pts had stage IV disease, 2 pts had stage III and 1 pt each had stage I and stage II. 8 pts had extranodal disease, 10 had B symptoms and 1 lymphomatous meningitis. Mean CD4 level 225 (105-330). All pts were evaluable for toxicity, 7 pts had grade 3 or 4 hematologic toxicity. Of the 9 pts who received greater than 3 cycles of chemotherapy, 6 required dose reductions of at least 25% or dose delay of at least 1 week due to hematological toxicity. Dose escalation was achieved in 3 pts. 2 pts had grade 3 mucositis. Constitutional symptoms related to GM-CSF were observed in 10 pts. Only 1 pt had an opportunistic infection during chemotherapy (TBC). 11 pts were evaluable for response, 7 pts achieved a complete response (63%), which continue for 6, 9+, 9+, 11, 12, 12+ and 15+ months, respectively. After completing chemotherapy 4/7 are still alive. GM-CSF and DDI can safely be administered with chemotherapy. DDI and TMS administered with chemotherapy may prevent opportunistic infections.
Keywords: Acquired Immunodeficiency Syndrome/*DRUG THERAPY Antineoplastic Agents, Combined/ADVERSE EFFECTS/*THERAPEUTIC USE Bleomycin/ADMINISTRATION & DOSAGE Cyclophosphamide/ADMINISTRATION & DOSAGE Didanosine/*THERAPEUTIC USE Doxorubicin/ADMINISTRATION & DOSAGE Etoposide/ADMINISTRATION & DOSAGE Granulocyte-Macrophage Colony-Stimulating Factor/*THERAPEUTIC USE Human HIV Seropositivity/*DRUG THERAPY Lymphoma, AIDS-Related/*DRUG THERAPY/MORTALITY/PATHOLOGY Methotrexate/ADMINISTRATION & DOSAGE Neoplasm Staging Survival Rate ABSTRACT CLINICAL TRIAL 951230
M95C3205
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Important note: Information in this article was accurate in 1995. The state of the art may have changed since the publication date.
