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Intensive treatment of AIDS‐related non‐Hodgkin's lymphomas with the MACOP‐B protocol
Author(s) -
Schürmann D.,
Grünewald T.,
Weiß R.,
Jautzke G.,
Pohle H. D.,
Ruf B.
Publication year - 1995
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/j.1600-0609.1995.tb01771.x
Subject(s) - medicine , methotrexate , lymphoma , chemotherapy , vincristine , non hodgkin's lymphoma , surgery , cyclophosphamide
The usefulness of intensive chemotherapy with the MACOP‐B protocol was evaluated in 8 patients with AIDS‐related non‐Hodgkin's lymphoma (NHL). Four patients had a prior AIDS diagnosis. The median CD4+ lymphocyte count was 0.079 cells × 10 9 /1 (range 0.016–0.330). All patients responded to treatment. Four patients finished chemotherapy, all with complete remission, while another 3 patients deteriorated prior to finishing treatment and died. The median survival was 4 months (range 1 to 86 months). Major causes of the poor outcome were AIDS‐related opportunistic infections and meningeal CNS involvement by NHL developing during or after chemotherapy. Patients with AIDS‐related NHL usually do not appear to benefit from treatment with MACOP‐B protocol. Advanced immunodeficiency is associated with poor tolerance to treatment and inability to finish this chemotherapy protocol. MACOP‐B chemotherapy does not prevent meningeal spread of lymphoma in spite of using repeatedly systemic methotrexate crossing the blood‐brain barrier. CNS prophylaxis with repeated application of intrathecal methotrexate may lower the risk of meningeal spread of lymphoma, which developed in 1 of 5 patients given CNS prophylaxis as compared to 2 of 3 patients without CNS prophylaxis.