The French-Italian Cooperative Study Group included patients with poor-prognosis
AIDS-related
non-Hodgkin's lymphoma (NHL), defined as those with performance status (PS) > or = 3 and/or
opportunistic infections (OI), in a prospective study with a 50% reduced-dose
combination chemotherapy regimen:
CHVmP-
Vincristine-bleo (
cyclophosphamide 300 mg/m2 i.v. day 1,
doxorubicin 25 mg/m2 i.v. day 1,
teniposide 30 mg/m2 i.v. day 1,
prednisone 20 mg/m2 per os days 1-5,
vincristine 2 mg i.v. day 15, and
bleomycin 10 mg i.v. day 15), given every 21 days for eight cycles, and concomitant
zidovudine 500 mg per os per day. The aims of this combined treatment were to reduce bone marrow toxicity and infectious complications related to
chemotherapy (with a low-dose
chemotherapy regimen), and to control the HIV and related infectious complications (with
zidovudine therapy). Thirty-seven patients entered this prospective study. At the time of the NHL diagnosis, 41% of the patients had asymptomatic
HIV infection, 27% had
ARC and 32% had already had CDC-defined diagnoses of
AIDS. The median CD4+ cell count was 35 mm3. Only 29 patients are evaluable for response, since 8 received only one cycle of
chemotherapy. Fifteen of 29 (52%) patients obtained objective responses, with only 4 (14%) achieving complete remissions (CR) of 1, 4, 14 and 29+ months. Three (16%) CRs were achieved in 19 evaluable patients included in the study because of poor PS, and only one CR was observed in 10 evaluable patients with histories of OI, either alone or with poor PS. The most common side effect was bone marrow toxicity with 2 related toxic deaths.(ABSTRACT TRUNCATED AT 250 WORDS)