AZT PLUS METHOTREXATE IN HIV-RELATED NON-HODGKINS-LYMPHOMAS

AZT is a thymidine analogue useful in the treatment of AIDS. It has be en demonstrated that this compound can possess a significant antineopl astic activity when combined with de novo thymidylate synthesis inhibi tors, such as 5-fluorouracil (5FU) and methotrexate (MTX). Here we rep ort a review of our data concerning the efficacy and tolerance of the combination AZT + MTX in HIV-related non Hodgkin's lymphomas (NHL). Tw enty-nine patients were treated, at weekly intervals, with three (pati ent 1 to 10) or six (patient 11 to 29) consecutive courses of MTX 1g/m (2) and increasing doses of oral AZT (2, 4 and 6g/m(2)) with leucovori n rescue. Of 26 evaluable patients, a total (complete + partial) respo nse rate of 77% was obtained. The median complete response duration wa s 16.8 months. There was one therapy-related death due to septic shock . Grade III-IV neutropenia was observed after 19% of the courses, but was prevented by G-CSF administration in 82/119 courses. Grade III-IV anemia was observed after 9% of the courses. In conclusion, the combin ation AZT + MTX was effective and well tolerated in our series of HIV- related NHL patients.