Intensive chemotherapy (codox-m/ivac) compares favorably with other regimens for HIV positive and negative patients with burkitt's lymphoma (BL) Academic Article uri icon

Overview

MeSH Major

  • Antineoplastic Combined Chemotherapy Protocols
  • Hodgkin Disease

abstract

  • Magrath et al. (JCO 14: 925-934,1996) have reported a 2 year event-free survival (EPS) rate of 92% in adult and p├ędiatrie HIV- patients (pts) with BL treated with CODOX-M/IVAC (cyclophosphamide, doxorabicin, high-dose methotrexate/ifosfamide, etoposide, high dose cytarabine). To confirm and compare these results to other treatments (tx), we retrospectively reviewed 38 newly diagnosed adults with BL treated at MSKCC between 1988-2000. Twenty-one pts (55%) received CODOX-M/IVAC; 17 received other tx including M-CHOP(ll). Twenty-two pts (58%) had stage IV disease (9 CNS, 16 bone marrow). Median follow-up was 17 mo (range 0-107). Fourteen pts (37%) were HIV+. BL was the AIDS defining illness in 6 pts. Four pts had prior anti-retroviral tx. Total (%) HIV+ HIV- CODOX-M/IVAC Otherchemo N=38 N=14 N=24 N=21 N=17 CR 24(66) 9(64) 15(63) 17(81) 7(47) Relapses 1 (3) 0 (0) 1 (7) 1 (5) 0 (0) Total deaths 16(42) 6(43) 10(42) 6(28) 10(59) Disease-related 11 (29) 4 (29) 7 (29) 2 (9) 9 (53) Toxic 3 (8) 1 (7) 2 (9) 2 (9) 1 (6) Overall survival 22(58) 8(57) 14(58) 15(72) 7(42) 6 of 11 pts (55%) with either CNS or marrow involvement achieved CR with CODOXM/ IVAC vs 0/7 with other tx. One year EPS benefit was seen in HIV- pts (p= 0.03), stage IV pts (p=0.05), and pts with positive marrow (p=0.04). A trend toward improved survival seen in all pts treated with CODOX-M/IVAC vs other tx. Treatment-related neutropenia (95% vs 65%), nadir fever (91 vs 58%) and documented infection (67 vs 29%) were more common after CODOX-M/IVAC. However, equivalent rates of sepsis (24%) and toxic death (<10%) were seen in both groups. Toxicity was similar for HIV+ and HIV- pts with all regimens. CONCLUSIONS: (1) Adult pts treated with CODOXM/IVAC had higher CR rates with more long-term survivors as compared to other tx. (2) Results were similar for HIV+ and HIV- pts with BL. CODOX-M/IVAC is appropriate for HIV+ pts with BL. (3) Although CODOX-M/IVAC compares favorably with other tx, our results are somewhat inferior to those of McGrath et al., most likely reflecting a difference in pt population.

publication date

  • December 2000

Research

keywords

  • Academic Article

Additional Document Info

volume

  • 96

number

  • 11 PART I