EPOCH and Rituximab to Treat Non-Hodgkin's Lymphoma in Patients With HIV Infection
Status:
Active, not recruiting
Trial end date:
2027-03-30
Target enrollment:
Participant gender:
Summary
Background:
- HIV-infected patients have a weakened immune system, and chemotherapy, which is used to
treat lymphoma, probably causes further damage to the immune system.
- Limiting the amount of immune damage due to chemotherapy might decrease the number of
infections and the risk of developing cancer in the future in HIV-infected patients with
non-Hodgkin's lymphoma.
Objectives:
- To determine whether reducing the total amount of chemotherapy using a specific
combination of drugs called EPOCH-R (etoposide, doxorubicin, vincristine,
cyclophosphamide and rituximab) will rid the body of lymphoma quickly while decreasing
the risk of infections and future cancers.
- To determine whether the lymphoma will remain undetectable for at least one year if
treatment is stopped one cycle after the patient enters remission.
Eligibility:
-Patients with non-Hodgkin's lymphoma and HIV infection 4 years of age and older who have not
been treated previously with rituximab or cytotoxic chemotherapy.
Design:
- Patients receive EPOCH-R in 3-week treatment cycles for at least three and no more than
six cycles.
- The lymphoma is evaluated using CT and PET scans at the end of treatment cycles 2 and 3.
A bone marrow biopsy is repeated after cycle 2 if a biopsy was initially positive on
screening for participation in the study.
- Anti-HIV therapy is stopped before chemotherapy begins and is restarted when EPOCH-R
treatment ends.
- Patients are monitored for treatment response with blood tests and imaging scans at
baseline, when treatment ends, 2 months after treatment ends and then every 3 to 6
months for a total of 24 months following chemotherapy.