Phase II trial of infusional cyclophosphamide, doxorubicin, and etoposide in patients with HIV-associated non-Hodgkin's lymphoma: An Eastern Cooperative Oncology Group Trial (E1494)

Joseph A. Sparano, Sandra Lee, Michael G. Chen, Tipu Nazeer, Avi Einzig, Richard F Ambinder, David H. Henry, Jane Manalo, Tianhong Li, Jamie H. Von Roenn

Research output: Contribution to journalArticle

Abstract

Purpose: To determine the effectiveness of an infusional chemotherapy regimen in patients with HIV-associated lymphoma treated before and after the use of highly active antiretroviral therapy (HAART) in routine clinical practice. Patients and Methods: Ninety-eight assessable patients with HIV-associated intermediate- or high-grade non-Hodgkin's lymphoma received cyclophosphamide 200 mg/m2/d, doxorubicin 12.5 mg/m2/d, and etoposide 60 mg/m2/d (CDE) given by continuous intravenous infusion for 4 days (96 hours) every 4 weeks plus filgrastim. Concurrent antiretroviral treatment consisted of the nucleoside analog didanosine in the first 43 patients enrolled before December 1996 (pre-HAART group), or HAART in the remaining 55 patients enrolled after that time (HAART group). Results: Complete response occurred in 44 patients (45%; 95% CI, 35% to 55%). Failure-free survival and overall survival (OS) at 2 years was 36% (95% CI, 26% to 46%) and 43% (95% CI, 33% to 53%), respectively. At the time of the analysis, 30% in the pre-HAART group were alive compared with 47% in the HAART group; when adjusted for varying length of follow-up, patients in the HAART group had improved OS (P = .039). Patients in the HAART group experienced less grade 4 nonhematologic toxicity (22% v 42%; P = .037), thrombocytopenia (31% v 52%; P = .033), and anemia (9% v27%; P = .021), and had fewer treatment-associated deaths (0% v 10%; P = .013). Conclusion: Infusional CDE is an effective and potentially curative regimen for patients with HIV-associated lymphoma. Patients treated in the HAART era have less chemotherapy-associated toxicity and improved survival.

Original languageEnglish (US)
Pages (from-to)1491-1500
Number of pages10
JournalJournal of Clinical Oncology
Volume22
Issue number8
DOIs
StatePublished - 2004

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Etoposide
Highly Active Antiretroviral Therapy
Non-Hodgkin's Lymphoma
Doxorubicin
Cyclophosphamide
HIV
Survival
Lymphoma
Didanosine
Drug Therapy
Nucleosides
Intravenous Infusions
Thrombocytopenia
Anemia

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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Phase II trial of infusional cyclophosphamide, doxorubicin, and etoposide in patients with HIV-associated non-Hodgkin's lymphoma : An Eastern Cooperative Oncology Group Trial (E1494). / Sparano, Joseph A.; Lee, Sandra; Chen, Michael G.; Nazeer, Tipu; Einzig, Avi; Ambinder, Richard F; Henry, David H.; Manalo, Jane; Li, Tianhong; Von Roenn, Jamie H.

In: Journal of Clinical Oncology, Vol. 22, No. 8, 2004, p. 1491-1500.

Research output: Contribution to journalArticle

Sparano, Joseph A. ; Lee, Sandra ; Chen, Michael G. ; Nazeer, Tipu ; Einzig, Avi ; Ambinder, Richard F ; Henry, David H. ; Manalo, Jane ; Li, Tianhong ; Von Roenn, Jamie H. / Phase II trial of infusional cyclophosphamide, doxorubicin, and etoposide in patients with HIV-associated non-Hodgkin's lymphoma : An Eastern Cooperative Oncology Group Trial (E1494). In: Journal of Clinical Oncology. 2004 ; Vol. 22, No. 8. pp. 1491-1500.
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abstract = "Purpose: To determine the effectiveness of an infusional chemotherapy regimen in patients with HIV-associated lymphoma treated before and after the use of highly active antiretroviral therapy (HAART) in routine clinical practice. Patients and Methods: Ninety-eight assessable patients with HIV-associated intermediate- or high-grade non-Hodgkin's lymphoma received cyclophosphamide 200 mg/m2/d, doxorubicin 12.5 mg/m2/d, and etoposide 60 mg/m2/d (CDE) given by continuous intravenous infusion for 4 days (96 hours) every 4 weeks plus filgrastim. Concurrent antiretroviral treatment consisted of the nucleoside analog didanosine in the first 43 patients enrolled before December 1996 (pre-HAART group), or HAART in the remaining 55 patients enrolled after that time (HAART group). Results: Complete response occurred in 44 patients (45{\%}; 95{\%} CI, 35{\%} to 55{\%}). Failure-free survival and overall survival (OS) at 2 years was 36{\%} (95{\%} CI, 26{\%} to 46{\%}) and 43{\%} (95{\%} CI, 33{\%} to 53{\%}), respectively. At the time of the analysis, 30{\%} in the pre-HAART group were alive compared with 47{\%} in the HAART group; when adjusted for varying length of follow-up, patients in the HAART group had improved OS (P = .039). Patients in the HAART group experienced less grade 4 nonhematologic toxicity (22{\%} v 42{\%}; P = .037), thrombocytopenia (31{\%} v 52{\%}; P = .033), and anemia (9{\%} v27{\%}; P = .021), and had fewer treatment-associated deaths (0{\%} v 10{\%}; P = .013). Conclusion: Infusional CDE is an effective and potentially curative regimen for patients with HIV-associated lymphoma. Patients treated in the HAART era have less chemotherapy-associated toxicity and improved survival.",
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T1 - Phase II trial of infusional cyclophosphamide, doxorubicin, and etoposide in patients with HIV-associated non-Hodgkin's lymphoma

T2 - An Eastern Cooperative Oncology Group Trial (E1494)

AU - Sparano, Joseph A.

AU - Lee, Sandra

AU - Chen, Michael G.

AU - Nazeer, Tipu

AU - Einzig, Avi

AU - Ambinder, Richard F

AU - Henry, David H.

AU - Manalo, Jane

AU - Li, Tianhong

AU - Von Roenn, Jamie H.

PY - 2004

Y1 - 2004

N2 - Purpose: To determine the effectiveness of an infusional chemotherapy regimen in patients with HIV-associated lymphoma treated before and after the use of highly active antiretroviral therapy (HAART) in routine clinical practice. Patients and Methods: Ninety-eight assessable patients with HIV-associated intermediate- or high-grade non-Hodgkin's lymphoma received cyclophosphamide 200 mg/m2/d, doxorubicin 12.5 mg/m2/d, and etoposide 60 mg/m2/d (CDE) given by continuous intravenous infusion for 4 days (96 hours) every 4 weeks plus filgrastim. Concurrent antiretroviral treatment consisted of the nucleoside analog didanosine in the first 43 patients enrolled before December 1996 (pre-HAART group), or HAART in the remaining 55 patients enrolled after that time (HAART group). Results: Complete response occurred in 44 patients (45%; 95% CI, 35% to 55%). Failure-free survival and overall survival (OS) at 2 years was 36% (95% CI, 26% to 46%) and 43% (95% CI, 33% to 53%), respectively. At the time of the analysis, 30% in the pre-HAART group were alive compared with 47% in the HAART group; when adjusted for varying length of follow-up, patients in the HAART group had improved OS (P = .039). Patients in the HAART group experienced less grade 4 nonhematologic toxicity (22% v 42%; P = .037), thrombocytopenia (31% v 52%; P = .033), and anemia (9% v27%; P = .021), and had fewer treatment-associated deaths (0% v 10%; P = .013). Conclusion: Infusional CDE is an effective and potentially curative regimen for patients with HIV-associated lymphoma. Patients treated in the HAART era have less chemotherapy-associated toxicity and improved survival.

AB - Purpose: To determine the effectiveness of an infusional chemotherapy regimen in patients with HIV-associated lymphoma treated before and after the use of highly active antiretroviral therapy (HAART) in routine clinical practice. Patients and Methods: Ninety-eight assessable patients with HIV-associated intermediate- or high-grade non-Hodgkin's lymphoma received cyclophosphamide 200 mg/m2/d, doxorubicin 12.5 mg/m2/d, and etoposide 60 mg/m2/d (CDE) given by continuous intravenous infusion for 4 days (96 hours) every 4 weeks plus filgrastim. Concurrent antiretroviral treatment consisted of the nucleoside analog didanosine in the first 43 patients enrolled before December 1996 (pre-HAART group), or HAART in the remaining 55 patients enrolled after that time (HAART group). Results: Complete response occurred in 44 patients (45%; 95% CI, 35% to 55%). Failure-free survival and overall survival (OS) at 2 years was 36% (95% CI, 26% to 46%) and 43% (95% CI, 33% to 53%), respectively. At the time of the analysis, 30% in the pre-HAART group were alive compared with 47% in the HAART group; when adjusted for varying length of follow-up, patients in the HAART group had improved OS (P = .039). Patients in the HAART group experienced less grade 4 nonhematologic toxicity (22% v 42%; P = .037), thrombocytopenia (31% v 52%; P = .033), and anemia (9% v27%; P = .021), and had fewer treatment-associated deaths (0% v 10%; P = .013). Conclusion: Infusional CDE is an effective and potentially curative regimen for patients with HIV-associated lymphoma. Patients treated in the HAART era have less chemotherapy-associated toxicity and improved survival.

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