Intensive treatment of AIDS-related non-Hodgkin's lymphomas with the MACOP-B protocol.

Abstract

The usefulness of intensive chemotherapy with the MACOP-B protocol was evaluated in 8 patients with AIDS-related non-Hodgkin's lymphoma (NHL). Four patients had a prior AIDS diagnosis. The median CD4+ lymphocyte count was 0.079 cells x 10(9)/l (range 0.016-0.330). All patients responded to treatment. Four patients finished chemotherapy, all with complete remission, while another 3 patients deteriorated prior to finishing treatment and died. The median survival was 4 months (range 1 to 86 months). Major causes of the poor outcome were AIDS-related opportunistic infections and meningeal CNS involvement by NHL developing during or after chemotherapy. Patients with AIDS-related NHL usually do not appear to benefit from treatment with MACOP-B protocol. Advanced immunodeficiency is associated with poor tolerance to treatment and inability to finish this chemotherapy protocol. MACOP-B chemotherapy does not prevent meningeal spread of lymphoma in spite of using repeatedly systemic methotrexate crossing the blood-brain barrier. CNS prophylaxis with repeated application of intrathecal methotrexate may lower the risk of meningeal spread of lymphoma, which developed in 1 of 5 patients given CNS prophylaxis as compared to 2 of 3 patients without CNS prophylaxis.

• Authors: D Schürmann, T Grünewald, R Weiss, G Jautzke, H D Pohle, B Ruf
• Journal: European journal of haematology (Eur J Haematol) Vol. 54 Issue 2 Pg. 73-7 (Feb 1995) ISSN: 0902-4441 [Print] England
• PMID: 7535244 (Publication Type: Journal Article, Review)

Chemical References

• Bleomycin
• Vincristine
• Doxorubicin
• Cyclophosphamide
• Leucovorin
• Prednisone
• Methotrexate

Topics

• Acquired Immunodeficiency Syndrome (complications, drug therapy, mortality)
• Adult
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Bleomycin (administration & dosage, therapeutic use)
• Cyclophosphamide (administration & dosage, therapeutic use)
• Doxorubicin (administration & dosage, therapeutic use)
• Humans
• Leucovorin (administration & dosage, therapeutic use)
• Lymphoma, AIDS-Related (drug therapy, etiology, mortality)
• Lymphoma, Non-Hodgkin (drug therapy, etiology, mortality)
• Male
• Methotrexate (administration & dosage, therapeutic use)
• Middle Aged
• Prednisone (administration & dosage, therapeutic use)
• Survival Analysis
• Vincristine (administration & dosage, therapeutic use)