(BETA) AZT Therapy Not Just for HIV/AIDS

(BETA) AZT Therapy Not Just for HIV/AIDS

Bulletin of Experimental Treatments for AIDS, No. 26; September 1995
Harvey Bartnof, MD

- Zidovudine with interferon helpful for adult T-cell leukemia-lymphoma - Implications that AZT may also work in HIV/AIDS by non-antiviral mechanisms

In the past, zidovudine (AZT, Retrovir) has been used only to treat those with HIV/AIDS. Consequently, anyone taking the medication was assumed to have HIV/AIDS. Two recent reports have found that AZT in combination with interferon alpha (IFN-alpha), is effective in the treatment of adult T-Cell Leukemia-Lymphoma (ATLL). ATLL is an uncommon complication of infection with the human T-cell lymphotropic virus type I (HTLV-I). (HIV was formerly known as HTLV-III, or the third discovered human T-cell lymphotropic virus.) ATLL is extremely resistant to standard chemotherapy, with a median survival time of less than 6 months.

Researchers from the University of Southern California School of Medicine and from Necker Hospital in Paris have reported on the beneficial effects of AZT and IFN-alpha in over half of ATLL patients resistant to standard chemotherapy. A complete remission was induced in 26% of participants.

The 2 reports were published in the June 29, 1995 New England Journal of Medicine. An accompanying editorial by Robert Gallo, MD, discoverer of HTLV-I and -II, and co-discoverer of HIV, appears in the same issue. Since ATLL is not believed to be due to active HTLV-I replication, Dr. Gallo believes that the AZT may be causing beneficial effects by other, non-antiviral mechanisms. Those other mechanisms are only hypotheses currently, and further research is needed to determine what they are. Dr. Gallo indicates that they are likely to be anticellular and/or immune-modulating effects.

The implication for HIV/AIDS is that AZT and other antiretroviral drugs may be causing beneficial effects by mechanisms other than interfering with HIV growth.

Gallo RC. A surprising advance in the treatment of leukemia. New England Journal of Medicine 332(26): 1783-1785. June 29, 1995.

Gill PS and others. Treatment of adult T-cell leukemia-lymphoma with a combination of interferon alpha and zidovudine. New England Journal of Medicine 332(26): 1744-1748. June 29, 1995.

Hermine O and others. Brief report: treatment of adult T-cell leukemia-lymphoma with zidovudine and interferon alpha. New England Journal of Medicine 332(26): 1749-1751. June 29, 1995.

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©1995. AEGIS.