Abstract
Methods Modifications of the US NCI regimen include rituximab (R), cyclophosphamide reduction [800 mg/m2 x 2 days], vincristine 2 mg cap, methotrexate (mtx) 3000 mg/m2, dual chemotherapy lumbar punctures and IVAC infusion (high risk pts). Antibiotic prophylaxis & growth factor support specified, 100% grade IV hematopoietic toxicities in the original regimen. HAART therapy at the discretion of the local MD. Pathology review included CD20, CD10, BCL2, BCL6, p53, Ki67, BLIMP1, IRF4/ MUM1 and EBV EBER. (Table 1)
Highlights
HIV associated BL remains of concern for toxicity of dose-intensive regimens used in HIV negative patients
Termination – counts did not recover within time frame 1 (3%) to begin cycle 4
5 pts withdrew due Treatment Completed per protocol
Summary
HIV associated BL remains of concern for toxicity of dose-intensive regimens used in HIV negative patients (pts). Less intensive regimens have a high relapse rate. We modified CODOX-M/IVAC hoping to preserve efficacy while improving tolerability, treatment related mortality (TRM). Primary object: improving 1 year overall survival (OS) from the historical 65 to 85%
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