Prognostic factors in the treatment of human immunodeficiency virus-associated non-Hodgkin's lymphoma: Analysis of AIDS Clinical Trials Group protocol 142—Low-dose versus standard-dose m-BACOD plus granulocyte-macrophage colony-stimulating factor Journal Article


Authors: Straus, D. J.; Huang, J.; Testa, M. A.; Levine, A. M.; Kaplan, L. D.; for the National Institute of Allergy and Infectious Diseases AIDS Clinical Trials Group
Article Title: Prognostic factors in the treatment of human immunodeficiency virus-associated non-Hodgkin's lymphoma: Analysis of AIDS Clinical Trials Group protocol 142—Low-dose versus standard-dose m-BACOD plus granulocyte-macrophage colony-stimulating factor
Abstract: Purpose: The overall results of chemotherapy in human immunodeficiency virus (HIV)-associated non-Hodgkin's lymphoma (NHL) have been poor. To define a subgroup of patients who may have a better outcome, an analysis of prognostic factors was performed of patients treated in AIDS Clinical Trials Group (ACTG) protocol 142, a phase III randomized trial of low-dose versus standard-dose methotrexate, bleomycin, doxorubicin, cyclophosphamide, vincristine, and dexamethasone (m-BACOD) plus granulocyte-macrophage colony- stimulating factor (GM-CSF) for the treatment of patients with newly diagnosed HIV-associated NHL. Materials and Methods: The following baseline variables were included as potential predictors of survival among 192 patients who received treatment: age; intravenous drug use (IVDU); specific type of sexual contact as risk factors (homosexual, bisexual, or heterosexual contact); prior AIDS diagnosis; CD4 cell count; serum lactic acid dehydrogenase (LDH); histology; Karnofsky performance status (KPS); stage; B symptoms; race (white/nonwhite); nodal involvement; extranodal involvement; number of extranodal sites; specific sites: bone marrow, liver, kidney, lung, or gastrointestinal tract; and treatment arm (standard-dose m-BACOD/low-dose m-BACOD). Results: Age greater than 35 years, IVDU, stages III/IV, and CD4 cell counts less than 100/μL were adverse prognostic factors in multivariate analyses using the Cox proportional hazards model. The median over-all survival for patients with none or one of the adverse factors was 46 weeks, with two was 44 weeks, and with three or four was 18 weeks. At 144 weeks, 29.5% of patients with none or one, 16.9% with two, and 0% with three or four factors were alive (P < .001). Conclusion: Long-term survival can be achieved in approximately one third of patients with HIV-associated NHL with favorable characteristics.
Keywords: adolescent; adult; cancer survival; child; controlled study; treatment outcome; middle aged; major clinical study; clinical trial; doxorubicin; methotrexate; human immunodeficiency virus infection; nuclear magnetic resonance imaging; computer assisted tomography; controlled clinical trial; randomized controlled trial; antineoplastic combined chemotherapy protocols; granulocyte macrophage colony stimulating factor; cyclophosphamide; dexamethasone; vincristine; age factors; biopsy; nonhodgkin lymphoma; bleomycin; lactate dehydrogenase; thorax radiography; multivariate analysis; phase 3 clinical trial; cd4 lymphocyte count; cd4 antigen; leucovorin; lymphoma, aids-related; lymphocyte count; granulocyte-macrophage colony-stimulating factor; humans; prognosis; human; priority journal; article
Journal Title: Journal of Clinical Oncology
Volume: 16
Issue: 11
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 1998-11-01
Start Page: 3601
End Page: 3606
Language: English
PUBMED: 9817281
PROVIDER: scopus
DOI: 10.1200/JCO.1998.16.11.3601
DOI/URL:
Notes: Article -- Export Date: 12 December 2016 -- Source: Scopus
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  1. David J Straus
    205 Straus