Opportunistic infection (OI) in patients with HIV-related non-Hodgkin's lymphoma (NHL) treated with infusional cyclophosphamide, doxorubicin and etoposide (CDE): a case control study (Meeting abstract).

Important note: Information in this article was accurate in 1995. The state of the art may have changed since the publication date.

Proc Annu Meet Am Assoc Cancer Res; 14:A823 1995. Unique Identifier : AIDSLINE ICDB/95613975
Sparano JA; Wiernik PH; Hu XP; Sarta C; Dutcher JP; Hanau L; Leaf A; Albert Einstein Cancer Center, Montefiore Medical Center, Bronx,; NY 10467

Abstract: We reported a 62% complete response rate and 18 month median survival for 30 patients (pts) with HlV-related NHL treated with CDE (Leukemia and Lymphoma 14:263, 1994; Proc ASCO 12:51, 1993), employed without antiretroviral therapy (N = 21) or in combination with didanosine (N = 9). In order to determine the effect of CDE on survival, quality of life, and immune function, we performed a case control study in which each pt with NHL (case) for whom adequate follow-up data were available (N = 27) was matched with 2 HIV+ controls without NHL or any other malignancy (matched for CD4 count, prior OI [+/-], and date of either initiation of CDE therapy or entry into the AIDS clinic). The characteristics of the case vs control groups, respectively, are: median CD4 100 vs 93/ul; prior OI 22% vs 25%; prior antiviral therapy 44% vs 42%; median age 39 vs 37 years; male 78% vs 62%; IV drug users 59% vs 49%. As expected, survival was inferior in cases compared with controls (59% +/- 9% vs 92% +/- 4% at 1 year [p less than 0.01], 45% +/- 11% vs 79% +/- 7% at 2 years [p less than 0.05]), a finding attributable to the 33% tumor-related mortality in the cases. The rate of AIDS-defining events (ADE; excluding CD4 less than 200/ul as an event) was 0.72 per person year in cases vs 0.51 in controls, yielding a relative risk of 1.42 for cases vs controls (95% confidence intervals 0.87, 1.64; p = 0.17); the study had an 80% power to detect a greater than or equal to 2.2-fold increase in the rate of ADE. The proportion of pts free of an ADE in cases vs controls was 61% (+/- 10%) vs 68% (+/- 6%) at 1 year, and 42% (+/- 12%) vs 51% (+/- 8%) at 2 years (p = 0.36). After 6-12 months, there were significantly greater decreases in cases vs controls for CD4+ (mean decrease 159 vs 55/ul; p less than 0.001), CD8+ (460 vs 140/ul; p less than 0.05), and total T lymphocytes (574 vs 183/ul; p less than 0.01). Conclusions: (1) Infusional CDE is active in HIV-related NHL, with about 45% of pts surviving 2 years; (2) CDE results in significant decreases in lymphocyte subsets; (3) there may be a modest increase in the relative risk of ADE (which were virtually all OIs) in pts treated with CDE, but a substantial proportion of surviving pts (40%) are free of ADE at 2 years; (4) CDE merits further study in combination with antiretroviral therapy in HIV-related NHL.

Keywords: Adult Antineoplastic Agents, Combined/*THERAPEUTIC USE AIDS-Related Opportunistic Infections/*EPIDEMIOLOGY/IMMUNOLOGY Case-Control Studies Comparative Study Confidence Intervals Cyclophosphamide/ADMINISTRATION & DOSAGE CD4 Lymphocyte Count Doxorubicin/ADMINISTRATION & DOSAGE Etoposide/ADMINISTRATION & DOSAGE Female Follow-Up Studies Human Lymphoma, AIDS-Related/COMPLICATIONS/*DRUG THERAPY/IMMUNOLOGY/ MORTALITY Male Risk Factors Survival Rate Time Factors ABSTRACT CLINICAL TRIAL CONTROLLED CLINICAL TRIAL
951230
M95C3225

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from Boehringer Ingelheim, Bridgestone/Firestone Charitable Trust, Bristol-Myers Squibb Company, Elton John AIDS Foundation, Gill Foundation, the National Library of Medicine, Quest Diagnostics, Roche and Trimeris, and donations from users like you. Always watch for outdated information. This article first appeared in 1995. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 1995. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .