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Chemotherapy Consisting of Doxorubicin, Bleomycin, Vinblastine, and Dacarbazine With Granulocyte–Colony-Stimulating Factor in HIV-Infected Patients With Newly Diagnosed Hodgkin's Disease: A Prospective, Multi-institutional AIDS Clinical Trials Group Study (ACTG 149)

 

作者: Alexandra Levine,   Ping Li,   Tony Cheung,   Anil Tulpule,   Jamie Von Roenn,   Bharat Nathwani,   Lee Ratner,  

 

期刊: JAIDS Journal of Acquired Immune Deficiency Syndromes  (OVID Available online 2000)
卷期: Volume 24, issue 5  

页码: 444-450

 

ISSN:1525-4135

 

年代: 2000

 

出版商: OVID

 

关键词: HIV;Hodgkin's disease;ABVD

 

数据来源: OVID

 

摘要:

To ascertain the results of standard ABVD chemotherapy (doxorubicin, bleomycin, vinblastine, dacarbazine) in HIV-infected patients with newly diagnosed Hodgkin's disease (HD), a nonrandomized, prospective, multiinstitutional clinical trial was conducted by the AIDS Clinical Trials Group (ACTG), in HIV-infected patients with Hodgkin's disease. All patients received the standard ABVD regimen, with granulocyte–colony-stimulating factor (G-CSF). Antiretroviral therapy was not used. Between May, 1992 and August, 1996, 21 patients were added to the study and treated. The median CD4 count was 113 cells/mm3, and 29% had a history of a clinical AIDS-defining condition before diagnosis of HD. Systemic “B” symptoms were present in 90% at diagnosis. Stage IV HD was present in 67%, with bone marrow involvement in 12 (57%). Nodular sclerosis HD was present in 38%, with mixed cellular disease in 31%. Among all patients entered and treated, complete remission (CR) was attained in 9 (43%; 90% confidence interval [CI], 24%–63%), whereas partial response occurred in 4 (19%), leading to an overall objective response rate of 62% (90% CI, 42%–79%). Despite routine use of G-CSF, 10 patients (47.6%) experienced life-threatening neutropenia, with absolute neutrophil counts <500 cells/mm3. In all, nine opportunistic infections occurred in 6 patients (29%) during the study or shortly thereafter. Median survival was 1.5 years. Results of this study suggest that alternative treatment strategies should be explored, including use of chemotherapy together with antiretroviral therapy.

 

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