Stanford V regimen and concomitant HAART in 59 patients with Hodgkin disease and HIV infection

Blood. 2002 Sep 15;100(6):1984-8. doi: 10.1182/blood-2002-03-0989.

Abstract

A phase 2 prospective study was performed to evaluate the feasibility and activity of a short, dose-intensive chemotherapy regimen and radiotherapy (the Stanford V regimen) plus highly active antiretroviral therapy (HAART) and granulocyte colony-stimulating factor (G-CSF) support in patients with Hodgkin disease and HIV infection. Fifty-nine patients were enrolled. Stanford V was well tolerated and 69% of the patients completed treatment with no dose reduction or delayed chemotherapy administration. The most important dose-limiting side effects were bone marrow toxicity and neurotoxicity. Complete remission was achieved by 81% of the patients, and after a median follow-up of 17 months 33 patients (56%) were alive and disease-free. The estimated 3-year overall survival (OS), disease-free survival (DFS), and freedom from progression (FFP) were 51%, 68%, and 60%, respectively. Probability of FFP was significantly (P =.02) higher among patients with an International Prognostic Score (IPS) of 2 or lower than in those with an IPS higher than 2, and the percentages of FFP at 2 years in these groups were 83% and 41%, respectively. Similarly, the probability of OS was significantly (P =.0004) different in the 2 groups, and the percentages of OS at 3 years were 76% and 33%, respectively. Our data confirm that the Stanford V regimen with concomitant HAART is feasible and active in an HIV setting. However, a more intensive approach should be considered in patients with high IPSs.

Publication types

  • Clinical Trial
  • Clinical Trial, Phase II
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / toxicity
  • Antiretroviral Therapy, Highly Active / methods*
  • Bleomycin / administration & dosage
  • Disease-Free Survival
  • Doxorubicin / administration & dosage
  • Etoposide / administration & dosage
  • HIV Infections / complications
  • HIV Infections / drug therapy*
  • HIV Infections / mortality
  • HIV-1
  • Hodgkin Disease / drug therapy*
  • Hodgkin Disease / mortality
  • Hodgkin Disease / virology
  • Humans
  • Lymphoma, AIDS-Related / drug therapy*
  • Lymphoma, AIDS-Related / mortality
  • Male
  • Mechlorethamine / administration & dosage
  • Middle Aged
  • Prednisone / administration & dosage
  • Prognosis
  • Prospective Studies
  • Remission Induction / methods
  • Survival Analysis
  • Survival Rate
  • Vinblastine / administration & dosage
  • Vincristine / administration & dosage

Substances

  • Bleomycin
  • Mechlorethamine
  • Vincristine
  • Vinblastine
  • Etoposide
  • Doxorubicin
  • Prednisone

Supplementary concepts

  • Stanford V protocol