Document 2993
 DOCN  M94A2993
 TI    Chemotherapy and didanosine (DDI) in AIDS-lymphoma.
 DT    9412
 AU    Harrington WJ; Ucar A; Cabral L; Lai S; Byrnes JJ; Univ. of Miami, FL.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):178 (abstract no. PB0138). Unique
       Identifier : AIDSLINE ICA10/94369582
 AB    OBJECTIVE: To explore the hypothesis that combined antiretroviral and
       antitumor chemotherapy is feasible and more effective. METHOD: A
       randomized clinical trial was undertaken of stage II-IV intermediate or
       high grade lymphoma. 16 pts were randomized to the DDI (+) arm and 14 to
       the DDI (-) arm. Chemotherapy was delivered over 12 weeks: mitoxantrone
       (8 mg/m2) and VP-16 (100 mg/m2) on odd weeks; cyclophosphamide 350 mg/m2
       on wks 1, 5, and 9; bleomycin (10 u/m2) and vincristine 2 mg on even
       weeks; and methylprednisolone (1g/m2) weekly. In addition, patients
       received prophylaxis with Bactrim, difluconazole and acyclovir. RESULTS:
       The response rate in the DDI(+) arm was 85% (61% CR and 25% PR) versus
       71% (43% CR and 28% PR) in the DDI (-) arm. The median duration of CR
       has been 50+ weeks. Logistic regression analyses show that a higher CD4
       count, a higher CD8 count, a higher serum albumin, a lower serum lactic
       dehydrogenase, and DDI usage were associated with complete remission and
       longer survival. DDI toxicities included: pancreatitis, paresthesias,
       and diarrhea. There was less febrile neutropenia in the DDI (+) arm.
       CONCLUSIONS: Concurrent chemotherapy and DDI is feasible and well
       tolerated. This treatment program is delivered over a short period of
       time (12) weeks, with acceptable toxicity and a high response rate.
 DE    Acquired Immunodeficiency Syndrome/*DRUG THERAPY/MORTALITY/  PATHOLOGY
       Antineoplastic Agents, Combined/*THERAPEUTIC USE  Combined Modality
       Therapy  Comparative Study  Didanosine/*THERAPEUTIC USE  Dose-Response
       Relationship, Drug  Drug Administration Schedule  Follow-Up Studies
       Human  Lymphoma, AIDS-Related/*DRUG THERAPY/MORTALITY/PATHOLOGY
       Neoplasm Staging  Remission Induction  Survival Rate  CLINICAL TRIAL
       MEETING ABSTRACT  RANDOMIZED CONTROLLED TRIAL

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