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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).
Giuliano M; Gastaldi R; Giannini G; Cordone I; Gentile G; Del Bianco P;
December 30, 1998
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