Excellent immunological recovery following CODOX-M/IVAC, an effective intensive chemotherapy for HIV-associated Burkitt's lymphoma.

Abstract

OBJECTIVE AND DESIGN:

: To retrospectively describe the recovery of cellular immunity and the clinical outcome of 30 patients with HIV-associated Burkitt's lymphoma (HIV-BL), who were treated with the intensive chemotherapy CODOX-M/IVAC and HAART as part of their standard care.

PATIENTS AND METHODS:

: Seventy-three percent of the patients had high-risk disease, defined by stage, performance status, extranodal sites and lactate dehydrogenase. The median CD4 cell count at diagnosis of HIV-BL was 171/ml (range: 4-848) and the plasma HIV viral load was undetectable in five of 29 patients.

RESULTS:

: Nine patients died during treatment (disease progression, three; toxicity, five; central nervous system lesion not biopsied, one). Response rate was 70% (complete response/complete response uncertain, 17; partial response, 4). After a median follow-up of 22 months (range: 6-72), 18 patients remain alive without disease progression. The 3-year overall survival and event-free survival were 52 and 75%, respectively. Viral load was undetectable in 88% and CD4 cell count more than 200/ml in 58% of patients assessed 6 months after completing chemotherapy, and in 87 and 80% at 12 months, respectively.

CONCLUSION:

: The intensive regimen CODOX-M/IVAC, a feasible and effective chemotherapy, is associated with an excellent immunological recovery in patients with HIV-BL on HAART.

• Authors: Silvia Montoto, Jamie Wilson, Kate Shaw, Maureen Heath, Andy Wilson, Christopher McNamara, Chloe Orkin, Mark Nelson, Margaret Johnson, Mark Bower, Kate Cwynarski
• Journal: AIDS (London, England) (AIDS) Vol. 24 Issue 6 Pg. 851-6 (Mar 27 2010) ISSN: 1473-5571 [Electronic] England
• PMID: 20124971 (Publication Type: Journal Article)

Chemical References

• Vincristine
• Doxorubicin
• Cyclophosphamide
• Methotrexate

Topics

• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage)
• Antiretroviral Therapy, Highly Active
• Burkitt Lymphoma (drug therapy, immunology, mortality)
• CD4 Lymphocyte Count
• Cyclophosphamide (administration & dosage)
• Disease-Free Survival
• Doxorubicin (administration & dosage)
• Female
• HIV Infections (drug therapy, immunology, mortality)
• Humans
• Lymphoma, AIDS-Related (drug therapy, immunology, mortality)
• Male
• Methotrexate (administration & dosage)
• Middle Aged
• Prognosis
• Retrospective Studies
• Treatment Outcome
• Vincristine (administration & dosage)