title: Treatment of AIDS-related non-Hodgkin's lymphoma with chemotherapy (CNOP) and r-hu-G-CSF: clinical outcome and effect on HIV-1 viral load.
abstract: OBJECTIVE
  The optimal treatment of AIDS-related NHL (ARL) has yet to be defined. The purpose of this study was 1) to evaluate the efficacy and toxicity of the CNOP-regimen (cyclophosphamide, mitoxantrone, vincristine, and prednison) in combination with G-CSF; and 2) to study the effect of this regimen on HIV-1 viral replication.
  
  
  METHODS
  A phase II study was performed in 21 previously untreated patients with ARL.
  
  
  RESULTS
  Based on intention to treat, the response rate was 43%: four complete and five partial remissions. Median survival was only five months. Only one patient had an opportunistic infection during treatment; three patients had localized infections and one episode of septicaemia was seen. Remarkably, during treatment, in 94% of cases p24 antigen levels either remained undetectable or showed a substantial decrease, even though antiretroviral therapy had been discontinued just prior to the first cycle of chemotherapy in all patients. HIV-1 RNA load decreased or remained unchanged in 82% of patients and increased in three patients.
  
  
  CONCLUSIONS
  Our data demonstrate, 1) that the CNOP-regimen in combination with G-CSF, although associated with a low risk of both opportunistic and bacterial infections, can not be recommended in the treatment of ARL; but 2) that G-CSF can be used safely to sustain haematopoiesis in patients with ARL treated with chemotherapy.
authors.affiliation: Department of Hematology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: M J
authors.initials: MJ
authors.lastname: Kersten
authors.forename: T J
authors.initials: TJ
authors.lastname: Verduyn
authors.forename: P
authors.initials: P
authors.lastname: Reiss
authors.forename: L M
authors.initials: LM
authors.lastname: Evers
authors.forename: F
authors.initials: F
authors.lastname: de Wolf
authors.forename: M H
authors.initials: MH
authors.lastname: van Oers
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000008:administration & dosage; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D015497:HIV-1 / Q000302:isolation & purification; D006801:Humans; D016483:Lymphoma, AIDS-Related / Q000097:blood / Q000188:drug therapy*; D008228:Lymphoma, Non-Hodgkin / Q000097:blood / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage; D011239:Prednisolone / Q000008:administration & dosage; D016019:Survival Analysis; D014750:Vincristine / Q000008:administration & dosage; D019562:Viral Load
chemical_list: D016179:Granulocyte Colony-Stimulating Factor; D014750:Vincristine; D003520:Cyclophosphamide; D011239:Prednisolone; D008942:Mitoxantrone