High dose idarubicin-based regimen for diffuse large cell AIDS-related non-Hodgkin's lymphoma patients: a pilot study

Citation
R. Gastaldi et al., High dose idarubicin-based regimen for diffuse large cell AIDS-related non-Hodgkin's lymphoma patients: a pilot study, HAEMATOLOG, 86(10), 2001, pp. 1051-1059
Citations number
40
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiovascular & Hematology Research
Journal title
HAEMATOLOGICA
ISSN journal
0390-6078 → ACNP
Volume
86
Issue
10
Year of publication
2001
Pages
1051 - 1059
Database
ISI
SICI code
0390-6078(200110)86:10<1051:HDIRFD>2.0.ZU;2-T
Abstract
Background and Objectives. Intensive chemotherapy (CHT) in AIDS-related non -Hodgkin's lymphoma (AIDS-NHL patients) is a vexing problem. Our purpose wa s to evaluate the feasibility of a high dose idarubicin (HD-IDA)-based regi men in diffuse large cell (DLC) AIDS-NHL patients. Design and Methods. Fourteen stage I-IV untreated DLC AIDS-NHL patients wit h a performance status <3 and no prior AIDS-related diseases received CIOD: cyclophosphamide, HD-IDA (25 mg/m(2) in 8 patients, 20 mg/m(2) in 6 patien ts) vincristine and dexamethasone plus granulocyte colony-stimulating facto r (G-CSF) and prophylaxis against infections. The outcomes measured were: r ate of response, disease-free survival (DFS), overall survival (OS) and the impact of chemotherapy on immunologic and virological parameters. Results. Complete response was achieved in 13/14 cases (response rate: 93%) . The median time of response and survival was 33 (range 5-79) and 35.5 (ra nge 6-84) months, respectively. At 60 months the DFS and OS were 71% and 44 %, respectively. CIOD with idarubicin 20 mg/m(2) was better tolerated than that with 25 mg/m(2) and was administered with a higher mean average-relati ve-dose-intensity (95.38 +/-7% vs 83.35 +/- 15.59%, p=0.0001). Opportunisti c infections were more frequent in patients with a baseline CD4 < 100 than those with > 100 cells/muL (4/5 vs 1/9: p=0.0229). After 3 CIOD courses the mean CD4 cells/muL was significantly lower (p=0.001) and the mean HIV.1 RN A load was significantly higher (p=0.045) than at baseline. Interpretation and Conclusions. The proposed chemotherapeutic regimen for A IDS-related non-Hodgkin's lymphoma is feasible in an outpatient setting in selected patients with relatively well-preserved immune function. (C) 2001, Ferrata Storti Foundation.