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(Drug information on doxorubicin) 25 mg/m² and vinblastine(Drug information on 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(Drug information on 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(Drug information on bleomycin) (Blenoxane) 5 mg/m² on weeks 2, 4, 6, 8, 10, and 12. Prednisone(Drug information on 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%).