Intravenous methotrexate for primary central nervous system non-Hodgkinʼs lymphoma in AIDS

Jacomet, Christine; Girard, Pierre‐Marie; Lebrette, Marie-Gisèle; Farese, Vannina Leca; Monfort, Laura; Rozenbaum, Willy

doi:10.1097/00002030-199714000-00009

Cited by 115 publications

(42 citation statements)

References 16 publications

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“…Survival may be improved in the HAART era, with patients responding to HAART treatment demonstrating extended median survivals to beyond 1.5 years [126]. Smaller reports in this population have also shown responses to high-dose methotrexate-based regimens without the associated leukoencephalopathy of whole-brain radiation [127]. Pilot studies have also suggested promise for therapy directed against EBV and HIV in the form of parenteral zidovudine, ganciclovir, and IL-2 along with HAART [128], although these results are still preliminary.…”

Section: Treatmentmentioning

confidence: 99%

AIDS-Related Malignancies: Emerging Challenges in the Era of Highly Active Antiretroviral Therapy

2005

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Human immunodeficiency virus (HIV)-infected patients are at increased risk of developing cancer, particularly in the later stages of acquired immune deficiency syndrome (AIDS). LEARNING OBJECTIVESAfter completing this course, the reader will be able to:1. Describe the pathogenesis and clinical presentation of Kaposi's sarcoma, with a special emphasis on Kaposi's sarcoma herpesvirus/human herpesvirus-8, and outline treatment approaches.2. Discuss the pathogenesis, epidemiology, and treatment of AIDS-related lymphomas.3. Discuss the increasing incidence of non-AIDS-defining malignancies such as Hodgkin's lymphoma and plasma cell disorders in patients with HIV infection.4. Explain how, in the era of highly active antiretroviral therapy, both AIDS-related lymphoma and Hodgkin's lymphoma patients may be treated with therapies previously reserved for their immunocompetent counterparts.Access and take the CME test online and receive 1 hour of AMA PRA category 1 credit at CME.TheOncologist.com CME CME by guest on May 11, 2018http://theoncologist.alphamedpress.org/ Downloaded fromThis material is protected by U.S.

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Section: Treatmentmentioning

confidence: 99%

AIDS-Related Malignancies: Emerging Challenges in the Era of Highly Active Antiretroviral Therapy

2005

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“…This approach resulted in a 50% complete response rate and a median survival of 10 months. 92 With the use of HAART, PCNSL therapy appears to have become more tolerable and as in non-HIV PCNSL, there has been more interest in using systemic chemotherapy with or without radiotherapy to improve quality of life and minimize long-term sequelae of radiotherapy alone. More recent cohort data suggest that immune recovery associated with HAART can dramatically improve survival.…”

Section: Primary Cns Lymphomamentioning

confidence: 99%

AIDS-related lymphoproliferative disease

Navarro

Kaplan

2006

Blood

101

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“…The concept of using high-dose MTX in PEL initially came from the observation of a patient with a secondary localization of PEL in the central nervous system (CNS) (case 1). As MTX has been successfully used in the treatment of AIDS-associated primary CNS lymphoma [8], this drug was added to the chemotherapy regimen. The achievement of a sustained complete remission (CR) in this patient as well as the potential for MTX to diffuse in the body cavities and to accumulate in serous effusions prompted us to use it in the chemotherapy given for PEL.…”

Section: Introductionmentioning

confidence: 99%

Combined chemotherapy including high‐dose methotrexate in KSHV/HHV8‐associated primary effusion lymphoma

et al. 2003

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Primary effusion lymphoma (PEL) is a rare KSHV/HHV8-associated high-grade nonHodgkin's lymphoma (NHL) of B-cell origin, characterized by serous effusions in body cavities. Most patients are HIV-infected homosexual men with severe immunosuppression and other KSHV/HHV8-associated diseases such as Kaposi's sarcoma (KS). The prognosis is poor with a median survival of less than 6 months in most cohorts. The achievement of a sustained complete remission is rare. High-dose chemotherapy regimens are warranted to improve complete remission rate and survival. Seven patients with AIDS-associated PEL were treated with a combined chemotherapy including high-dose methotrexate followed by leucovorin rescue. In all cases, KSHV/HHV8 sequences were detected in the effusion samples using quantitative PCR assays. Five patients had a pre-existing KS, associated in three cases with multicentric Castleman's disease (MCD). Upon diagnosis, 6 patients received antiretroviral therapy, which was maintained during chemotherapy in 5 of them. At time of analysis, 3 out of 7 patients were in complete remission 18, 26, and 78 months after PEL diagnosis. Three patients died with a progressive PEL at 22, 67, and 153 days after diagnosis, and 1 patient died 9 months after PEL diagnosis with a MCD-associated plasmablastic NHL. Complete remission was obtained in 3 out of 7 patients treated for AIDS-associated PEL with combined chemotherapy containing high-dose methotrexate. Am.

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Intravenous methotrexate for primary central nervous system non-Hodgkinʼs lymphoma in AIDS

Abstract: Methotrexate appears to be an attractive alternative to radiation therapy for primary CNS lymphoma and is associated with a far greater improvement in quality of life relative to historical series of radiation therapy.

Cited by 115 publications

References 16 publications

AIDS-Related Malignancies: Emerging Challenges in the Era of Highly Active Antiretroviral Therapy

AIDS-Related Malignancies: Emerging Challenges in the Era of Highly Active Antiretroviral Therapy

AIDS-related lymphoproliferative disease

Combined chemotherapy including high‐dose methotrexate in KSHV/HHV8‐associated primary effusion lymphoma

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