HIV-Associated Burkitt Lymphoma: Good Efficacy and Tolerance of Intensive Chemotherapy Including CODOX-M/IVAC with or without Rituximab in the HAART Era
Background. The outcome of HIV-associated non-Hodgkin lymphoma (NHL) has improved substantially in the highly active antiretroviral therapy (HAART) era. However, HIV-Burkitt lymphoma (BL), which accounts for up to 20% of HIV-NHL, has poor outcome with standard chemotherapy. Patients and Methods. We...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2012-01-01
|
| Series: | Advances in Hematology |
| Online Access: | http://dx.doi.org/10.1155/2012/735392 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Summary: | Background. The outcome of HIV-associated non-Hodgkin lymphoma (NHL) has improved substantially in the highly active antiretroviral therapy (HAART) era. However, HIV-Burkitt lymphoma (BL), which accounts for up to 20% of HIV-NHL, has poor outcome with standard chemotherapy. Patients and Methods. We retrospectively reviewed HIV-BL treated in the HAART era with the Magrath regimen (CODOX-M/IVAC±R) at four Canadian centres. Results. Fourteen patients with HIV-BL received at least one CODOX-M/IVAC±R treatment. Median age at BL diagnosis was 45.5 years, CD4 count 375 cells/mL and HIV viral load (VL) <50 copies/mL. Patients received PCP prophylaxis and G-CSF, 13 received HAART with chemotherapy and 10 rituximab. There were 63 episodes of toxicity, none fatal, including: bacterial infection, n=20; grade 3-4 hematologic toxicity, n=14; febrile neutropenia, n=7; oral thrush; and ifosfamide neurological toxicity, n=1 each. At a median followup of 11.7 months, 12 (86%) patients are alive and in remission. All 10
patients who received HAART, chemotherapy, and rituximab are alive. CD4 counts and HIV VL 6 months following BL therapy completion (n=5 patients) were >250 cells/mL
and undetectable, respectively, in 4. Conclusion.
Intensive chemotherapy with
CODOX-M/IVAC±R
yielded acceptable toxicity and good survival rates in patients
with HIV-associated Burkitt lymphoma receiving
HAART. |
|---|---|
| ISSN: | 1687-9104 1687-9112 |