ORLANDOUse of highly active antiretroviral therapy (HAART) has
significantly changed the prognosis of human immunodeficiency disease (HIV).
However, the outcomes of patients with Hodgkin’s disease (HD) in the HIV
setting are still poor. According to Michele Spina, MD, this is mainly due to
the short duration of complete response.
Dr. Spina, of the Division of Medical Oncology, National Cancer Institute,
Aviano, Italy, was lead author of a study of previously untreated HIV-infected
patients with Hodgkin’s disease presented at a poster session of the 43rd
Annual Meeting of the American Society of Hematology (ASH abstract 573).
Patients received an intensive 12-week chemotherapy protocol (Stanford V)
with adjuvant radiotherapy and concomitant HAART. Patients had bulky limited
disease or stage III/IV disease. Of the original 49 patients enrolled in the
study, 46 were evaluable for toxicity and 45 for response.
The chemotherapy regimen included doxorubicin 25 mg/m² and vinblastine 6
mg/m² on weeks 1, 3, 5, 7, 9, and 11; mechlorethamine (Mustargen) 6 mg/m² on
weeks 1, 5, and 9; etoposide (VePesid) 60 mg/m² on days 1 and 2 on weeks 3, 7,
and 11; vincristine 1.4 mg/m² with a maximum dose of 2 mg and bleomycin
(Blenoxane) 5 mg/m² on weeks 2, 4, 6, 8, 10, and 12. Prednisone was
administered every other day.
The median age of the patients was 36 years (range, 28 to 63 years).
"All patients but five were males," Dr. Spina said. "Twenty
patients were intravenous drug users, and there were 14 homosexuals and 12
heterosexuals among the cohort." The median CD4+ cell count at time of
entry to the study was 225/mm³ (range, 32 to 1,008); 27 the patients had a
detectable HIV viral load (median, 3,600 copies/mm³). Stage III and IV disease
was present in 33 patients (72%).