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NLM AIDSLINE

Effect on virological and immunological parameters of concomitant antiretroviral therapy and antineoplastic chemotherapy (CT) in AIDS-related non-Hodgkin's lymphoma patients (AIDS-NHL pts).




 

Int Conf AIDS. 1998;12:1090 (abstract no. 60487). Unique Identifier :

OBJECTIVE: To evaluate the virological and immunological effects of the administration of antiretroviral therapy during antineoplastic chemotherapy in AIDS-NHL pts. METHODS: Out of 6 consecutive AIDS-NHL Pts, 5 diffuse large cell B phenotype and 1 anaplastic CD30+/CD20+ lymphomas, 3 patients received CIOD (Cyclophosphamide, Idarubicin, Vincristine, Desametasone) regime with G-CSF (Group A) and the other 3 received the same regimen associated with combination antiretroviral therapy with stavudine (d4T) and didanosine (ddI) (Group B). Plasma viral load and immunological parameters were evaluated at these time points: before the start of therapy, after the third cycle and one month after the end of CT. RESULTS: At NHL diagnosis, the two groups of patients (A vs B) were similar for age, sex, NHL stage, immunological parameters and viral load (5.5 +/- 0.45 vs 4.1 +/- 0.8 logs: p = 0.09). At NHL diagnosis, two Pts in group A were CDC stage B3 and one was in stage B2 while in group B one was CDC stage B3 and two were stage C3. A significant difference between the two groups of patients (A vs B) was found after the third cycle of CT of the following parameters: viral load (5.9 +/- 0.3 vs 3.3 +/- 0.78 logs, p = 0.005) and mean absolute cell counts/mm3 of lymphocytes (166 +/- 57 vs 1000 +/- 100, p = 0.001), of CD3+ (116 +/- 72 vs 712 +/- 119, p = 0.005), of CD3+/CD4+ (27 +/- 32 vs 133 +/- 41, p = 0.02) and of CD3+/CD8+ (70 +/- 41 vs 412 +/- 124, p = 0.04). Out of these parameters, only viral load remained significantly different one month after the end of CT (5.6 +/- 0.6 vs 3.1 +/- 0.9 logs, p = 0.032). Opportunistic infections occurred in two patients in group A and in one patient in group B. CONCLUSIONS: This study showed that the use of combined d4T and ddI therapy during CT is well tolerated, improves immunological parameters and determines a decrease of viral load in AIDS-NHL Pts. However, a larger number of AIDS-NHL Pts are needed to evaluate the impact of this combined treatment on the frequence of opportunistic infections during CT.

MEETING ABSTRACTS CLINICAL TRIAL Anti-HIV Agents/*THERAPEUTIC USE Antineoplastic Agents/*THERAPEUTIC USE Antineoplastic Agents, Combined/THERAPEUTIC USE Cyclophosphamide/THERAPEUTIC USE Dexamethasone/THERAPEUTIC USE Didanosine/THERAPEUTIC USE Drug Therapy, Combination Granulocyte Colony-Stimulating Factor/THERAPEUTIC USE Human Idarubicin/THERAPEUTIC USE Lymphoma, AIDS-Related/*DRUG THERAPY Lymphoma, Large-Cell/DRUG THERAPY Lymphoma, Non-Hodgkin/*DRUG THERAPY Stavudine/THERAPEUTIC USE Vincristine/THERAPEUTIC USE Viral Load



 




Information in this article was accurate in December 30, 1998. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.