Effects of recombinant granulocyte colony-stimulating factor (G-CSF) in patients treated with ProMACE-CytaBOM for HIV-related non-Hodgkin's lymphoma (NHL).

Abstract

BACKGROUND AND OBJECTIVE:

The use of hematopoietic growth factors in association with chemotherapy in human immunodeficiency virus (HIV)-related non-Hodgkin's lymphoma (NHL) has been recommended, but few studies have evaluated its cost-effectiveness.

DESIGN AND METHODS:

The effects of recombinant granulocyte colony-stimulating factor (G-CSF) were analyzed in 33 consecutive patients with HIV-related NHL treated at a single institution with the same chemotherapy program, ProMACE-CytaBOM, with G-CSF, in 21 cases diagnosed after December 31, 1991, or without G-CSF, in 12 cases diagnosed earlier. Pearson's chi-square analysis and the two-sided Student's t-test were used for statistical comparisons. The method of Kaplan-Meyer and the log-rank-test were used for survival analyses.

RESULTS:

G-CSF support significantly reduced the frequency of day-1 drug dose reductions (p < 0.001) and of chemotherapy delays (p < 0.001), and improved the actual delivered doses of adriamycin, cyclophosphamide and etoposide (p < 0.02). In patients with a CD4+ count < 0.01 x 10(9)/L, chemotherapy could be given at full doses in 90% of cycles with G-CSF compared to only 20% without it. G-CSF affected neither the frequency and duration of fever and hospitalization nor the complete remission and survival rates after stratification according to the CD4+ count.

INTERPRETATION AND CONCLUSIONS:

G-CSF support significantly improved dose-intensity in patients with HIV-related NHL treated with aggressive chemotherapy, particularly in the subgroup with a CD4+ count < 0.1 x 10(9)/L, but it did not improve their clinical outcome.

• Authors: G Rossi, A Donisi, S Casari, A Re, R Stellini, G Cadeo, G Carosi
• Journal: Haematologica (Haematologica) Vol. 83 Issue 4 Pg. 317-22 (Apr 1998) ISSN: 0390-6078 [Print] Italy
• PMID: 9592981 (Publication Type: Clinical Trial, Comparative Study, Journal Article)

Chemical References

• Recombinant Proteins
• Cytarabine
• Bleomycin
• Granulocyte Colony-Stimulating Factor
• Vincristine
• Etoposide
• Doxorubicin
• Cyclophosphamide
• Prednisone
• Methotrexate

Topics

• Adult
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Bleomycin (administration & dosage)
• Cohort Studies
• Cyclophosphamide (administration & dosage)
• Cytarabine (administration & dosage)
• Doxorubicin (administration & dosage)
• Etoposide (administration & dosage)
• Female
• Granulocyte Colony-Stimulating Factor (therapeutic use)
• HIV
• Humans
• Lymphoma, AIDS-Related (drug therapy)
• Lymphoma, Non-Hodgkin (drug therapy)
• Male
• Methotrexate (administration & dosage)
• Middle Aged
• Prednisone (administration & dosage)
• Recombinant Proteins (therapeutic use)
• Retrospective Studies
• Treatment Outcome
• Vincristine (administration & dosage)