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Concurrent cART + EPOCH in HIV-Related Lymphoma
Leuk Lymphoma; ePub 2017 Nov 21; Tan, et al
In patients with HIV-associated high-grade B-cell non-Hodgkin lymphoma (NHL), cART + EPOCH is well-tolerated and appears to lead to faster immune recovery, according to a recent study. However, survival outcomes are similar to those who received delayed cART treatment. Participants with HIV-associated high-grade B-cell NHL received DA-EPOCH with rituximab. cART was given with the treatment or delayed. Investigators looked at pharmacokinetic, immunological, and treatment effects of concurrent vs delayed cART. Among the results:
- CD4 counts dropped in all patients.
- The counts recovered to higher than baseline in the cART group 6 months after EPOCH.
- HIV viral load decreased during chemotherapy in the cART group.
- Viral load increased in the non-cART group.
- Grade ≥3 infectious, hematologic, and neurological toxicities were similar in both contingents.
- Concurrent cART was not linked with better 1-year event-free or overall survival.
Tan C, Barta S, Lee J, Rudek M, Sparano A, Noy A. Combination antiretroviral therapy accelerates immune recovery in patients with HIV-related lymphoma treated with EPOCH: a comparison within one prospective trial AMC034. [Published online ahead of print November 21, 2017]. Leuk Lymphoma. doi:10.1080/10428194.2017.1403597.