Patient entry to this protocol was begun in FY 1992. Eligible patients include patients infected with HIV with high-grade or intermediate grade non-Hodgkin's lymphomas known to be associated with AIDS. The treatment regimen is designed to afford therapeutic and curative doses of antilymphoma drugs provided by continuous infusion in order to minimize toxicity and improve the efficacy as compared with conventional bolus drug delivery, based on previous experience with non-AIDS associated lymphomas. G-CSF is used to enhance recovery from neutropenia and ddl is added to provide anti-retroviral therapy. To date, 10 patients have been entered on this protocol. All are available for toxicity and 7 are evaluable for response. Toxicity has been considerable, despite modest drug doses and the use of G-CSF. Six patients (of 10) experienced Grade IV neutropenia and 3 had Grade III neutropenia. 5/10 had Grade III or IV increases in transaminases (not certain whether these were treatment, lymphoma, or HIV-related abnormalities). Three patients died during treatment, 2 of progressive lymphoma and 1 of complications of far advanced AIDS despite complete regression of lymphoma. Of the 7 evaluable for response (not including 1 patient with Hodgkin's disease incorrectly diagnosed, and 2 patients who died after only one cycle of chemotherapy, 1 with no response and 1 with no tumor found at autopsy), there are 4 complete responses (CR), and 3 with no or minor responses. These results are consistent with expectations. We plan to continue this trial, making enhanced efforts to improve accrual.
