AZT-GRADE HIV-RELATED NON-HODGKIN LYMPHOMAS - INTERIM-REPORT ON FEASIBILITY AND TOLERANCE(METHOTREXATE IN HIGH)

Background. 3'azido-3'deoxythymidine (AZT) is a thymidine analogue use ful in the treatment of AIDS, We have previously demonstrated that AZT can possess significant antineoplastic activity when combined with de novo thymidylate synthesis inhibitors, such as 5-fluorouracil or meth otrexate (MTX), We report here on the feasibility and tolerance of the combination AZT+MTX in the treatment of HIV-related non-Hodgkin lymph omas (NHL). Patients and Methods. IV-positive patients with high-grade NHL were treated, at weekly intervals, with three consecutive courses of MTX 1 g/m(2) plus increasing doses of oral AZT (2, 4 and 6 g/m(2)) and folinic acid rescue. Results. From July 1992 to lune 1994, 16 pat ients were enrolled in the trial after giving informed consent. Grade III-IV neutropenia was observed after 22% of the courses, but was prev ented by G-CSF administration in 34/59 courses. Grade III-IV anemia wa s observed after 15% of the courses, No non hematological toxicity was observed. Conclusions. The combination AZT+MTX was extremely well tol erated in this series of HIV-related NHL patients. If these results ar e confirmed in terms of antineoplastic efficacy, the protocol will des erve wider application.