Gemcitabine Is An Active Agent In Acquired Human Immunodeficency HIV Related Lymphomas

Abstract 4951

Gemcitabine is a cell cycle phase specific cytotoxic agent. It's phosphorylated products inhibit ribonucleotide reductase an enzyme responsible for DNA synthesis. It also competes with the incorporation of deoxycytosine triphospate (dCTP) into the DNA strands. After Gemcitabine is incorporated into the DNA the growing DNA strands will stop. Gemcitabine has proven to be an active cytotoxic agent in the treatment of lymphomas, either as a single agent or in combination with platinum and dexamethsone. Gemcitabine efficacy has not been investigated in the treatment of HIV patients with Lymphomas. The purpose of this abstract is to show our experience with this agent in HIV related lymphomas. This summarize the experience with three patients. First patient is 42 years old white male with diffuse large B cell type Non-Hodgkin's Lymphoma involving the right psoas muscle and invading the pelvic nerve roarts causing intractable pain that has not been resonsive to CHOP (four cycles), the third patient is a 55 years old hispanic female with stage IV Hodgkin's Lymphoma (mixed cellularity) that has failed ABVD × 6 cycles and progressed in less than two months from completion of treatment. This patient presented with B symptoms and cachexia at relapse. The third patient is 50 years old black male with stage III Immunoblastic B Cell Lymphoma who failed EPOCH. All patients were on HAART medication and viral load were undetectable in two of these patient (2,3). The first patient received Gemcitabine alone. With two weekly doses of 1000mg/M2 the pain resolved and he stopped narcotics and was refered to other institution for autologus bone marrow transplant. The second patient received two cycles of Gemcitabine, Cisplatin and Decadron within one dose the B symptoms and the sever bony pain have disappeared completely. The third patient completed six cycles of treatment; each cycle is of twenty eight days duration; Gemcitabine 1000mg/M2 given IV on week one and two(day1) and Cisplatinum 80/M2 mg given IV on day one with decadron 40 mg po with each chemotherapy treatment. This patient has been in complete remisson and is alive after three years. In conlusion: Gemcitabine is an active agent that can be used safely in HIV/AIDS patients with lymphomas with good results.