Published in Cancer Detection and Prevention 2000; 24(Supplement 1).

Visceral kaposi’s sarcoma in AIDS patients treated with combined ABV chemotherapy and G-CSF

A Mastroianni 1, C Cancellieri 1, O Coronado 2, R Manfredi 2, F Chiodo 2

1 Div Infectious Diseases, “GB Morgagni” General Hospital, Forlì,, 2 Institute of Infectious Diseases, University of Bologna, Italy

AIM: To assess the safety and efficacy of G-CSF support in AIDS patients with Kaposi's sarcoma (KS) treated with adriamycin, bleomycin, and vincristine (ABV). METHODS: 41 AIDS patients with biopsy-proven visceral and/or cutaneous KS were included in this study. These patients received prophylactically G-CSF (5 mcg/kg of body weight per day) s.c. for 3-5 days before chemotherapy with ABV (adriamycin, 20 mg/m2 , bleomycin 10 mg/m2 , and vincristine 1.4 mg/m2) until the ANC was higher than 25 x 109; G-CSF was then discontinued 3-5 days before chemotherapy. Patients were elegible to resume G-CSF 3 days after completing the anticancer treatment until normalization of the ANC occurred. The concomitant use of mono- or combined antiretroviral therapy was possible in most cases. RESULTS: A complete clinical response was achieved in 20% of patients and a partial, temporary regression of KS lesions was observed in 40% of patients. Adverse reactions included moderate headache in 40% of patients, and moderate bone pain in 30%. A moderate anemia was observed in 30% of patients, and a grade II-III neutropenia in 35%. The mean duration of neutropenia was 3 days. Plasma HIV antigenemia or HIV RNA PCR was decreased in plasma samples obtained from 30% of patients and remained unchanged in the other patients. Median survival was 12 months and median response duration was 8 months. CONCLUSIONS: These data suggest that G-CSF should be considered as a therapeutic agent, possibly associated with concomitant antiretroviral therapy, in the management of patients with AIDS-associated KS.

KEY WORDS: Kaposi’s sarcoma, Hemopoietic Growth Factors, Neutropenia.

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Paper presented at the International Symposium on Impact of Biotechnology on Cancer Diagnostic & Prognostic Indicators; Geneva, Switzerland; October 28 - 31, 2000; in the section on synergistic therapies.