Background: Optimal treatment of human immunodeficiency virus (HIV)-associated non-Hodgkin lymphoma (NHL) has yet to be defined, because chemotherapy could exacerbate immunodeficiency, with subsequent adverse effects for patients.
Methods: The authors investigated the feasibility of an intensive chemotherapy regimen for HIV-associated NHL. Thirty-eight patients were treated with a first course of cyclophosphamide (Cy), vincristine, and prednisone; followed by 3 courses of high-dose Cy (2000 mg/m2), doxorubicin (Doxo; 50 mg/m2), vincristine, and prednisone (modified high-dose CHOP); 1 course of high-dose methotrexate (MTX; 8000 mg/m2); and 1 course of high-dose cytarabine (8000 mg/m2). Radiotherapy was added to the treatment regimen for patients with bulky disease or residual tumor. Chemotherapy was administered in conjunction with granulocyte-colony-stimulating factor and antiretroviral therapy.
Results: Patients received 91.5%, 93%, 66%, and 63% of the scheduled doses of Cy, Doxo, MTX, and cytarabine, respectively. The complete response rate was 60.5%, with a total response rate of 79%. The 40-month overall survival rate was 43%, the disease-free survival rate was 65%, and the recurrence-free survival rate was 39%. Both an International Prognostic Index score of 0 or 1 and Burkitt-type histology had positive effects on survival, whereas CD4-positive lymphocyte counts, viral burden, and previous highly active antiretroviral therapy did not. CD4-positive T lymphocyte levels decreased from 0.197 +/- 0.156 x10(9)/L before treatment to 0.152 +/- 0.1 x10(9)/L at 6 months after the end of treatment. A decrease in viral load, from 380,000 +/- 785,000 copies/mL before treatment to 25,000 +/- 43,000 copies/mL at 6 months after the end of treatment, also was observed.
Conclusions: The results of the current study indicate that intensive chemotherapy is effective and tolerable for patients with HIV-associated NHL.
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http://dx.doi.org/10.1002/cncr.20019 | DOI Listing |
BMC Pediatr
December 2024
Department of Pediatrics, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China.
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December 2024
Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand.
Background: Lithium disilicate occlusal veneers are popular for minimally invasive posterior teeth restoration. The aim of this study was to compare the fatigue resistance and crack pattern of lithium disilicate occlusal veneers fabricated using pressing and milling techniques with varying thicknesses.
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Surg Endosc
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Department of Gastrointestinal Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-City, Saitama, Japan.
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View Article and Find Full Text PDFSci Rep
December 2024
Institute of Landscape Ecology, University of Münster, Münster, Germany.
Migratory animals rely on multiple sites during their annual cycles. Deteriorating conditions at any site can have population-level consequences, with long-distance migrants seen as especially susceptible to such changes. Reduced adult survival caused by persecution at non-breeding sites has been suggested a major reason for the catastrophic decline of a formerly abundant, long-distance migratory songbird, the Yellow-breasted Bunting Emberiza aureola.
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