Second International Congress Drug Therapy in HIV Infection 18-22 November 1994 Glasgow, UK

407 PATIENTS (PTS) WITH AIDS-RELATED NON-HODGKIN'S LYMPHOMA (AIDS-NHL): THE EXPERIENCE OF THE GICAT (ITALIAN COOPERATIVE GROUP ON AIDS AND TUMORS) WITH EMPHASIS ON THE PROSPECTIVE TREATMENT OF 93 PTS AT A SINGLE INSTITUTION.

U. Tirelli, M. Spina, E. Vaccher, A. Carbone and D. Serraino
For the GICAT, C.R.O. Aviano - Italy

Int Cong Drug Therapy HIV 1994 Nov 18-22;2:Abstract No. 10.2
AIDS 1994, Vol. 8 (Suppl. 4);S9

Since November 1986, we have collected data on 407 pts with peripheral AIDS-NHL observed in several Italian institutions of the GICAT. 62% of pts were intravenous drug users (IVDUs) in accordance to the overall epidemiology of HIV infection in Italy, 83% were males, the median age was 30 years. At diagnosis of AIDS-NHL, CD4 < 100/mm³ were detected in 46% of the pts, and opportunistic infections (OIs,CI according to COC) preceded or accompanied the NHL in 41% of the pts. Immunoblastic and Burkitt were diagnosed in 58% and 20% of the pts, respectively; advanced (III and IV) stage and B symptoms were present in 80% and 69% of the pts, respectively. Median survival of the overall population was 6 months; by the Cox model four factors were associated with a significantly shorter survival: advanced stage, heterosexuality, no treatment received and not having obtained a CR. At the Aviano Cancer Center, in the same period of time 93 of these pts have been treated according to prospective protocols. Based on HlV-related prognostic factors pts with unfavourable histology and stage III and IV were treated with intensive third generation chemotherapy regimens (group I, usually with CD4 > 200, good PS and without 01), with palliative chemotherapy with just 1 or 2 drugs or local RT (group 3, usually with CD4 < 100, poor PS and with 01) or with standard CHOP-like chemotherapy regimens (group 2, the remaining pts). The table reports the parameters that reached statistical significance in the comparison between the 3 groups of evaluable pts.

A significantly higher CR rate has been observed in group 1 pts, but with a concomitant increase of OIs during CT and follow up, in comparison to group 2 pts. However group 1 pts had a 1.5 decreased risk of dying in comparison to group 2 and 3 pts. Overall, 13 pts with a CR lasting for at least 2 years had a 42-month median survival with none of such pts relapsing even after 6 years. In conclusion, we have observed a large number of peripheral AIDS-NHL, mainly with immunoblastic and Burkitt subtypes, advanced stage and B symptoms. In the prospective treatment at a single institution, intensive chemotherapy regimens were associated both to higher CR rate and higher OIs during CT and follow up, with some pts experiencing long survival and possibly cure. The potential role of bone marrow growth factors in order to decrease bone marrow toxicity and more efficacious OI prophylactic therapy are currently prospectively tested.

Supported by AIRC grants.

Presenting author: U. Tirelli

1994-11-18
10.2

Originally published in AIDS Volume 8, Supplement 4 and hosted with permission of the publisher Lippincott Williams & Wilkins, 250 Waterloo Road, London, SE1 8RD, UK. Tel: +44 (0)20 7981 0700 Fax: +44 (0) 7981 0701

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