A new regimen consisting of cyclophosphamide, vinblastine, etoposide, and prednisolone (CVEP) is safe and effective in patients with diffuse large B-cell lymphoma (DLBCL) and plasmablastic lymphomas (PBL) related to acquired immunodeficiency syndrome (AIDS), according to a new study published in the British Journal of Haematology

This new regimen can overcome the limitations of cyclophosphamide, vinblastine, etoposide, prednisolone, and doxorubicin, the first-line therapy for AIDS-related DLBCL and PBL. These limitations include the need for central venous access, growth factors, and significant toxicity.

The researchers analyzed the safety and efficacy of the new regimen in a single-center, phase 2 clinical trial in 42 patients with systemic AIDS-related DLBCL and PBL. The patients were 18 years of age or older.

Read more about DLBCL comorbidities

The primary outcome measure of the trial was the complete response rate. Secondary outcome measures were the incidence of grade 3 or 4 toxicities, toxicities requiring hospitalization, and disease-free survival. 

The results showed that at the end of the treatment, the complete response rate was 69% in the intention-to-treat population and 80.5% in evaluable patients. 

The median follow-up was 69 months. At that time, the 5-year disease-free survival was 65.3%. 

A total of 217 cycles of CVEP were administered, and out of these, febrile neutropenia occurred in 19.3%, while hospitalization was needed in 18.3% of cycles. 

Notably, there were 2 treatment-related deaths.

“The present study has confirmed the activity of the CVEP regimen in AIDS-related DLBCL and PBL with an acceptable safety profile,” the researchers concluded. 

DLBCL is a type of non-Hodgkin lymphoma characterized by B cells becoming infiltrating tissues and organs in a widespread, diffuse pattern. The disease affects many tissues and organs, making it fatal if left untreated. PBL is an uncommon but aggressive subtype of DLBCL.

Reference

Sengar M, Jain H, Shet T, et al. Phase II trial of a novel chemotherapy regimen CVEP (cyclophosphamide, vinblastine, etoposide, and prednisolone) for acquired immunodeficiency syndrome (AIDS)-associated lymphomas. Br J Haematol. Published online November 2, 2022. doi:10.1111/bjh.18532