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

• Published in: Journal of acquired immune deficiency syndromes (1999) Vol. 24; no. 5; pp. 444 - 450
• Main Authors: Levine, Alexandra M, Li, Ping, Cheung, Tony, Tulpule, Anil, Von Roenn, Jamie, Nathwani, Bharat N, Ratner, Lee
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins, Inc 15-08-2000; Lippincott Williams & Wilkins
• Subjects: Adult; AIDS/HIV; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Bleomycin - administration & dosage; CD4 Lymphocyte Count; Dacarbazine - administration & dosage; Doxorubicin - administration & dosage; Drug Therapy, Combination; Experimental viral diseases and models; Female; Fundamental and applied biological sciences. Psychology; Granulocyte Colony-Stimulating Factor - administration & dosage; Granulocyte Colony-Stimulating Factor - therapeutic use; HIV Infections - complications; HIV Infections - drug therapy; Hodgkin Disease - complications; Hodgkin Disease - drug therapy; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Infectious diseases; Karnofsky Performance Status; Male; Medical sciences; Microbiology; Middle Aged; Prospective Studies; Vinblastine - administration & dosage; Viral diseases; Granulocyte; Doxorubicin; Osteoarticular system; Dacarbazine; Alkaloid; Granulocyte colony stimulating factor; Isomerases; Bleomycin; Glycopeptide; Lymphoproliferative syndrome; Antiviral; Diagnosis; Antimitotic; Human; Immunopathology; DNA topoisomerase (ATP-hydrolysing); Vinblastine; Leukopenia; Enzyme; Retroviridae; Enzyme inhibitor; Hodgkin disease; AIDS; Malignant hemopathy; Immune deficiency; Lentivirus; Lymphoma; Colony stimulating factor; Standards; Infection; Virus; Alkylating agent; Chemotherapy; Treatment; Viral disease; Anthracyclins; Human immunodeficiency virus
• ISSN: 1525-4135; 1944-7884
• DOI: 10.1097/00042560-200008150-00009

To ascertain the results of standard ABVD chemotherapy (doxorubicin, bleomycin, vinblastine, dacarbazine) in HIV-infected patients with newly diagnosed Hodgkinʼs disease (HD), a nonrandomized, prospective, multiinstitutional clinical trial was conducted by the AIDS Clinical Trials Group (ACTG), in HIV-infected patients with Hodgkinʼs 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/mm, 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/mm. 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.