AZT+methotrexate in high-grade HIV-related non-Hodgkin lymphomas: interim report on feasibility and tolerance.
BACKGROUND
3' azido-3' deoxythymidine (AZT) is a thymidine analogue useful in the treatment of AIDS. We have previously demonstrated that AZT can possess significant antineoplastic activity when combined with de novo thymidylate synthesis inhibitors, such as 5-fluorouracil or methotrexate (MTX). We report here on the feasibility and tolerance of the combination AZT+MTX in the treatment of HIV-related non-Hodgkin lymphomas (NHL).


METHODS
IV-positive patients with high-grade NHL were treated, at weekly intervals, with three consecutive courses of MTX 1 g/m2 plus increasing doses of oral AZT (2, 4 and 6 g/m2) and folinic acid rescue.


RESULTS
From July 1992 to June 1994, 16 patients were enrolled in the trial after giving informed consent. Grade III-IV neutropenia was observed after 22% of the courses, but was prevented by G-CSF administration in 34/59 courses. Grade III-IV anemia was observed after 15% of the courses. No non hematological toxicity was observed.


CONCLUSIONS
The combination AZT+MTX was extremely well tolerated in this series of HIV-related NHL patients. If these results are confirmed in terms of antineoplastic efficacy, the protocol will deserve wider application.
Tosi
P
P
Istituto di Ematologia, L. e A. Seràgnoli, University of Bologna, Italy.
Gherlinzoni
F
F
Visani
G
G
Coronado
O
O
Chiodo
F
F
Tura
S
S
D000328:Adult; D016022:Case-Control Studies; D004359:Drug Therapy, Combination; D005240:Feasibility Studies; D005260:Female; D006679:HIV Seropositivity / Q000188:drug therapy*; D006801:Humans; D016483:Lymphoma, AIDS-Related / Q000188:drug therapy*; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008727:Methotrexate / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D015215:Zidovudine / Q000009:adverse effects / Q000627:therapeutic use*
D015215:Zidovudine; D008727:Methotrexate