Low-dose interferon alpha combined with zidovudine in patients with AIDS-associated Kaposi's sarcoma.
Forty patients with AIDS-associated Kaposi's sarcoma (KS) treated with the combination of interferon alpha-2b (IFN-alpha) 10-20 MU day-1 and zidovudine (ZDV), 500-800 mg day-1, were evaluated for safety and efficacy. Eighteen patients (45%) had an overall response (CR+PR) at 3 months and a response persisting for a median of 14 (3-27) months. Patients with a CD4 count of less than 300 mm-3, prior to opportunistic infections or constitutional symptoms, were less likely to respond. However, between 28.5% and 36% of patients with a low CD4 count did respond to combined therapy. This is higher than would be predicted from single agent IFN-alpha therapy. Twelve of 28 patients (42.8%) receiving 10 MU day-1 of IFN-alpha (low dose) had an overall response. In addition, patients tolerated this dose of IFN-alpha better, presenting fewer flu-like symptoms and displayed a trend toward less anaemia. p24 antigen decreased in six out of nine evaluable cases, four of whom were treated with low-dose IFN-alpha. Low-dose IFN-alpha plus ZDV seems to be a useful and well-tolerated therapy for KS with antitumoral and antiviral activity. Patients without 'bad prognostic markers' are most likely to show improvement.
Podzamczer
D
D
Service of Infectious Diseases, Hospital de Bellvitge, Barcelona, Spain.
Bolao
F
F
Clotet
B
B
García
P
P
Casanova
A
A
Pagerols
X
X
Gudiol
F
F
D000163:Acquired Immunodeficiency Syndrome / Q000276:immunology / Q000628:therapy*; D000328:Adult; D015496:CD4-Positive T-Lymphocytes; D004359:Drug Therapy, Combination; D005260:Female; D016655:HIV Core Protein p24 / Q000032:analysis; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D016131:Lymphocyte Subsets; D008297:Male; D010157:Palatal Neoplasms / Q000276:immunology / Q000628:therapy; D011379:Prognosis; D011994:Recombinant Proteins; D012514:Sarcoma, Kaposi / Q000276:immunology / Q000628:therapy*; D012878:Skin Neoplasms / Q000276:immunology / Q000628:therapy; D013274:Stomach Neoplasms / Q000276:immunology / Q000628:therapy; D015215:Zidovudine / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use
D016655:HIV Core Protein p24; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D015215:Zidovudine