ANTIRETROVIRAL THERAPY AND CHEMOTHERAPY IN PATIENTS WITH HIV INFECTION AND HAEMATOLOGICAL DISEASE - TOXICITY ASSESSMENT
(Abstract release date: 05/19/16)
EHA Library. Gaspar Brandao de Sousa e Sant . 06/09/16; 132734; E1185
Dr. Paula Cristina Gaspar Brandao de Sousa e Sant
Contributions
Contributions
Abstract
Abstract: E1185
Type: Eposter Presentation
Background
Haematological malignancies, especially lymphoproliferative diseases, are a common manifestation of infection with human immunodeficiency virus (HIV). With highly active antiretroviral therapy (HAART) the survival of infected patients with hematologic disease has increased, and in most cases, overlapping the general population. Concomitant use of HAART and chemotherapy (CT) has been advocated for enhancing the immune response.
Aims
Characterization of toxicity associated with the concomitant use of HAART and CT and its impact on prognosis.
Methods
Descriptive, observational, retrospective study to evaluate patients with haematological malignancies associated with HIV infection and under HAART during CT, admitted between January 2011 and August 2015. The data was analysed using SPSS V17.0 program.
Results
We evaluated 24 patients, 19 males. The median age was 45.5 years (27-61). 22 patients had HIV-1, 1 patient HIV-2 and 1 patient co-infected with HIV-1 and HIV-2. All patients were on ARVT, 47.8% with regimens based on two nucleoside reverse transcriptase inhibitors (NRTI) and boosted protease inhibitor (PI/ r) and 34.8% with 2 NRTI-based regimens and integrase inhibitor (II). The most common diagnosis was Burkitt's lymphoma (29.2%), followed by diffuse large B-cell lymphoma (25%) and Hodgkin Disease (16.7%). The CD4 cell count was below 250cells/ mcL in 10 patients and none had negative viral load at the start of CT. We documented 120 complications, most infectious (50.8%). Organ toxicity was revealed in 11 patients, of which 35% had renal and 20% liver toxicity. Of the 7 patients who experienced renal toxicity, 6 were treated with regimens containing tenofovir. Of the 4 patients who experienced liver toxicity, 2 were treated with PI/ r and 2 with II. It was necessary to suspend HAART in 5 patients. The scheme has been changed in two. The median of administered chemotherapy cycles was 4 (1-8) with an overall response rate of 77.8% (n=14), 50% (n=9) complete response, 27.8% (n=5) partial response, 4 patients were refractory, and the remaining (n=6) were not evaluated. The overall survival at 2 years was 36.4% (4/11).
Conclusion
The use of HAART associated with CT is not absent of toxicities, sometimes forcing its suspension. The new generation of antiretroviral drugs, with less pharmacokinetic interactions with antineoplastic drugs, seems to contribute to better compliance with HAART. The impact of this association should continue to be evaluated in further studies with larger samples.
Session topic: E-poster
Keyword(s): Chemotherapy, HAART, Hematological malignancy, HIV
Type: Eposter Presentation
Background
Haematological malignancies, especially lymphoproliferative diseases, are a common manifestation of infection with human immunodeficiency virus (HIV). With highly active antiretroviral therapy (HAART) the survival of infected patients with hematologic disease has increased, and in most cases, overlapping the general population. Concomitant use of HAART and chemotherapy (CT) has been advocated for enhancing the immune response.
Aims
Characterization of toxicity associated with the concomitant use of HAART and CT and its impact on prognosis.
Methods
Descriptive, observational, retrospective study to evaluate patients with haematological malignancies associated with HIV infection and under HAART during CT, admitted between January 2011 and August 2015. The data was analysed using SPSS V17.0 program.
Results
We evaluated 24 patients, 19 males. The median age was 45.5 years (27-61). 22 patients had HIV-1, 1 patient HIV-2 and 1 patient co-infected with HIV-1 and HIV-2. All patients were on ARVT, 47.8% with regimens based on two nucleoside reverse transcriptase inhibitors (NRTI) and boosted protease inhibitor (PI/ r) and 34.8% with 2 NRTI-based regimens and integrase inhibitor (II). The most common diagnosis was Burkitt's lymphoma (29.2%), followed by diffuse large B-cell lymphoma (25%) and Hodgkin Disease (16.7%). The CD4 cell count was below 250cells/ mcL in 10 patients and none had negative viral load at the start of CT. We documented 120 complications, most infectious (50.8%). Organ toxicity was revealed in 11 patients, of which 35% had renal and 20% liver toxicity. Of the 7 patients who experienced renal toxicity, 6 were treated with regimens containing tenofovir. Of the 4 patients who experienced liver toxicity, 2 were treated with PI/ r and 2 with II. It was necessary to suspend HAART in 5 patients. The scheme has been changed in two. The median of administered chemotherapy cycles was 4 (1-8) with an overall response rate of 77.8% (n=14), 50% (n=9) complete response, 27.8% (n=5) partial response, 4 patients were refractory, and the remaining (n=6) were not evaluated. The overall survival at 2 years was 36.4% (4/11).
Conclusion
The use of HAART associated with CT is not absent of toxicities, sometimes forcing its suspension. The new generation of antiretroviral drugs, with less pharmacokinetic interactions with antineoplastic drugs, seems to contribute to better compliance with HAART. The impact of this association should continue to be evaluated in further studies with larger samples.
Session topic: E-poster
Keyword(s): Chemotherapy, HAART, Hematological malignancy, HIV
Abstract: E1185
Type: Eposter Presentation
Background
Haematological malignancies, especially lymphoproliferative diseases, are a common manifestation of infection with human immunodeficiency virus (HIV). With highly active antiretroviral therapy (HAART) the survival of infected patients with hematologic disease has increased, and in most cases, overlapping the general population. Concomitant use of HAART and chemotherapy (CT) has been advocated for enhancing the immune response.
Aims
Characterization of toxicity associated with the concomitant use of HAART and CT and its impact on prognosis.
Methods
Descriptive, observational, retrospective study to evaluate patients with haematological malignancies associated with HIV infection and under HAART during CT, admitted between January 2011 and August 2015. The data was analysed using SPSS V17.0 program.
Results
We evaluated 24 patients, 19 males. The median age was 45.5 years (27-61). 22 patients had HIV-1, 1 patient HIV-2 and 1 patient co-infected with HIV-1 and HIV-2. All patients were on ARVT, 47.8% with regimens based on two nucleoside reverse transcriptase inhibitors (NRTI) and boosted protease inhibitor (PI/ r) and 34.8% with 2 NRTI-based regimens and integrase inhibitor (II). The most common diagnosis was Burkitt's lymphoma (29.2%), followed by diffuse large B-cell lymphoma (25%) and Hodgkin Disease (16.7%). The CD4 cell count was below 250cells/ mcL in 10 patients and none had negative viral load at the start of CT. We documented 120 complications, most infectious (50.8%). Organ toxicity was revealed in 11 patients, of which 35% had renal and 20% liver toxicity. Of the 7 patients who experienced renal toxicity, 6 were treated with regimens containing tenofovir. Of the 4 patients who experienced liver toxicity, 2 were treated with PI/ r and 2 with II. It was necessary to suspend HAART in 5 patients. The scheme has been changed in two. The median of administered chemotherapy cycles was 4 (1-8) with an overall response rate of 77.8% (n=14), 50% (n=9) complete response, 27.8% (n=5) partial response, 4 patients were refractory, and the remaining (n=6) were not evaluated. The overall survival at 2 years was 36.4% (4/11).
Conclusion
The use of HAART associated with CT is not absent of toxicities, sometimes forcing its suspension. The new generation of antiretroviral drugs, with less pharmacokinetic interactions with antineoplastic drugs, seems to contribute to better compliance with HAART. The impact of this association should continue to be evaluated in further studies with larger samples.
Session topic: E-poster
Keyword(s): Chemotherapy, HAART, Hematological malignancy, HIV
Type: Eposter Presentation
Background
Haematological malignancies, especially lymphoproliferative diseases, are a common manifestation of infection with human immunodeficiency virus (HIV). With highly active antiretroviral therapy (HAART) the survival of infected patients with hematologic disease has increased, and in most cases, overlapping the general population. Concomitant use of HAART and chemotherapy (CT) has been advocated for enhancing the immune response.
Aims
Characterization of toxicity associated with the concomitant use of HAART and CT and its impact on prognosis.
Methods
Descriptive, observational, retrospective study to evaluate patients with haematological malignancies associated with HIV infection and under HAART during CT, admitted between January 2011 and August 2015. The data was analysed using SPSS V17.0 program.
Results
We evaluated 24 patients, 19 males. The median age was 45.5 years (27-61). 22 patients had HIV-1, 1 patient HIV-2 and 1 patient co-infected with HIV-1 and HIV-2. All patients were on ARVT, 47.8% with regimens based on two nucleoside reverse transcriptase inhibitors (NRTI) and boosted protease inhibitor (PI/ r) and 34.8% with 2 NRTI-based regimens and integrase inhibitor (II). The most common diagnosis was Burkitt's lymphoma (29.2%), followed by diffuse large B-cell lymphoma (25%) and Hodgkin Disease (16.7%). The CD4 cell count was below 250cells/ mcL in 10 patients and none had negative viral load at the start of CT. We documented 120 complications, most infectious (50.8%). Organ toxicity was revealed in 11 patients, of which 35% had renal and 20% liver toxicity. Of the 7 patients who experienced renal toxicity, 6 were treated with regimens containing tenofovir. Of the 4 patients who experienced liver toxicity, 2 were treated with PI/ r and 2 with II. It was necessary to suspend HAART in 5 patients. The scheme has been changed in two. The median of administered chemotherapy cycles was 4 (1-8) with an overall response rate of 77.8% (n=14), 50% (n=9) complete response, 27.8% (n=5) partial response, 4 patients were refractory, and the remaining (n=6) were not evaluated. The overall survival at 2 years was 36.4% (4/11).
Conclusion
The use of HAART associated with CT is not absent of toxicities, sometimes forcing its suspension. The new generation of antiretroviral drugs, with less pharmacokinetic interactions with antineoplastic drugs, seems to contribute to better compliance with HAART. The impact of this association should continue to be evaluated in further studies with larger samples.
Session topic: E-poster
Keyword(s): Chemotherapy, HAART, Hematological malignancy, HIV
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