10th Anniversary Conference Of The British HIV Association [BHIVA] 15 – 17 April 2004, City Hall, Cardiff, UK

[AUTHOR(S):] N McCall-Peat, N Ryan, L Davies, AM Young, MR Nelson, BG Gazzard, M Bower
Chelsea and Westminster Hospital, London, UK

BHIVA Conf 2004 Apr 15-17;10:O30

BACKGROUND: Pharmacokinetic interactions between chemotherapy and highly active antiretroviral therapy (HAART) are described but their clinical relevance has largely been overlooked.

METHODS: 46 patients with non-Hodgkin's lymphoma were treated with concomitant HAART and infusional cyclophosphamide, doxorubicin, etoposide (CDE) chemotherapy. A total of 190 cycles of CDE were administered, 48 with a protease inhibitor (PI) (11 patients) and 142 (35 patients) with PI-sparing HAART regimens. Neutrophil counts were measured on days 1, 7, 10, 14, 21 and 28 and the number of days of granulocyte colony-stimulating factor (G-CSF) recorded for each cycle.

RESULTS: There were no significant differences in CD4 count, HIV viral load, lymphoma stage, histological subtype or international prognostic index group or in the presence of bone marrow infiltration by lymphoma between the two groups (all P>0.05). The day 10 neutrophil count nadir was significantly lower in patients receiving PIs (P=0.012), although there was no difference in the number of days of G-CSF administered between groups (P=0.16). Infectious episodes were recorded for 66% cycles with PIs and 27% cycles without PIs (P<0.0001).

CONCLUSIONS: PI-based HAART potentiates the myelotoxicity of CDE chemotherapy and this is believed to be a consequence of microsomal enzyme inhibition reducing the metabolism of cytotoxics, particularly etoposide in this regimen.

PRESENTING AUTHOR: N McCall-Peat

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040415
O30

Copyright © 2004 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD