Low-dose chemotherapy with central nervous system prophylaxis and zidovudine maintenance in AIDS-related lymphoma: a prospective multi-institutional trial
Article Abstract:
Malignant lymphoma refers to cancerous growth of tissue in the lymphatic system, and includes Hodgkin's disease and lymphatic leukemia. During the 1980s it was found that higher doses of chemotherapy were more effective against disseminated (widespread) malignant lymphoma than lower doses. Lymphoma is one of the recognized complications of acquired immunodeficiency syndrome (AIDS), and has a median survival time of about six months in these patients, with death usually the result of infection. Unlike other patients with lymphoma, patients with human immunodeficiency virus (HIV) do poorly when treated intensively. Forty-two patients with lymphoma were treated with low-dose multiagent chemotherapy, with central nervous system (CNS) protection because of frequent CNS involvement among these patients. The antiviral agent zidovudine (AZT) was also administered to prevent AIDS-related complications. The median survival was six and a half months, similar to median survival times expected with the more intensive regimens. Four of those who responded have survived with no complications for three to four years. Relapse of lymphoma was relatively infrequent, but many of those who benefited from chemotherapy died of other AIDS-related causes, and one committed suicide. Patients with AIDS require effective antiretroviral intervention in addition to treatment for lymphoma in order to survive longer periods without other complications. Patients who had had AIDS prior to chemotherapy were less likely to do well, as were those with low numbers of CD4 lymphocytes (a type of white blood cell). The results of the study suggest that there is no advantage to delaying chemotherapy because of concurrent opportunistic infections. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1991
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Serum erythropoietin titers in patients with human immunodeficiency virus (HIV) infection and anemia
Article Abstract:
The human immunodeficiency virus (HIV) causes dysfunction of the body's immune system. It also causes other abnormalities of the blood system, including anemia due either to low levels of hemoglobin, the oxygen carrying pigment of red blood cells, or reduced numbers of red blood cells. How and why anemia occurs in individuals infected with HIV is not known. The growth factor erythropoietin (EPO) promotes the maturation of red blood cells and is released by the body when levels of oxygen in the tissues become too low. Levels of EPO were examined in 110 individuals who were infected with HIV and at various stages of disease, including AIDS and ARC (AIDS-related complex). There was an inverse relationship between EPO and hemoglobin levels in patients with AIDS or ARC who were not being treated with zidovudine (ZDV): those who were very anemic, with low hemoglobin levels, had high levels of EPO and visa versa, indicating a response by the body to counteract the anemia. Patients who were being treated with ZDV and were anemic had EPO levels ranging from normal to very high. This lack of correlation in individuals who were being treated indicates that the cause of anemia may not be the same among the patients and that ZDV may affect the EPO response and its effect on red blood cells. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journal of Acquired Immune Deficiency Syndromes
Subject: Health
ISSN: 0894-9255
Year: 1991
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Advanced acquired immune deficiency syndrome-related Kaposi's sarcoma: results of pilot studies using combination chemotherapy
Article Abstract:
Kaposi's sarcoma is common among patients with AIDS, and is present at the initial diagnosis of AIDS in almost 10 percent of the cases. Although the tumor can be controlled by chemotherapy, the use of effective doses is prohibited by the depressed state of the immune system in these patients. The bone marrow suppression resulting from chemotherapy combined with the preexisting immune deficiency usually leaves the patient vulnerable to opportunistic infections. Indeed, most patients treated for Kaposi's sarcoma die of infection with Pneumocystis carinii, which causes pneumonia. In order to determine if a more conservative regimen of chemotherapy might prove to be effective against Kaposi's sarcoma, 33 patients were treated with a combination of doxorubicin, bleomycin, and vincristine. Two different dosages of doxorubicin were evaluated. Eight patients achieved complete responses and 18 achieved partial responses, for a total response rate of 79 percent. While the drug combination proved to be efficacious, opportunistic infections were common among the patients. A total of 23 patients developed opportunistic infections, 17 with Pneumocystis carinii. In addition, the duration of the response itself was short, with all patients relapsing by twelve weeks from the end of treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Cancer
Subject: Health
ISSN: 0008-543X
Year: 1990
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