OBJECTIVE: To investigate the incidence of dose adjustments, delays and discontinuation of chemotherapy and the incidence of antineoplastic drug related toxicity in patients treated for lymphoma combined with cART, as well as differences between patients with PI-based and NNRTI-based cART. DESIGN AND METHODS: A retrospective observational cohort study was conducted among HIV-infected adult patients with cART who have been diagnosed with lymphoma and treated with cyclophosphamide, doxorubicin and/or vinca alkoloids, which interact with CYP3A4. Toxic events were identified and classified as renal, hepatic or bone marrow toxicity. Time of administration and dosage of antineoplastic drugs were collected to determine dose adjustments, delay and discontinuation of the chemotherapy and the clinical outcome of chemotherapy was registered. RESULTS: 50 HIV-positive patients were included of which 22 patients used PI-based and 21 NNRTI-based cART. HIV-positive patients with cART had more toxicity than HIV-negative patients. No significant differences in toxicity were observed between patients with PI-based and NNRTI-based cART, apart from a trend that patients with PI-based cART suffered more severe or life-threatening bone marrow toxicity. Patients with PI-based cART applied significantly earlier dose reduction and treatment delay than with NNRTI-based cART. No significant differences in clinical outcome of the chemotherapy were found between PI-based and NNRTI-based cART, but cART achieved less complete remission compared to HIV-negative patients. CONCLUSION: Patients with PI-based cART applied earlier dose adjustments and delays due to toxicity than patients with NNRTI-based cART. A prospective study should enhance the knowledge of the clinical pharmacology of the drug-drug interaction between antineoplastic and antiretroviral agents.
|Number of pages||5|
|Publication status||Published - 7 Jun 2013|