We evaluated risk factors for neutropenic fever and febrile prolonged neutropenia during vincristine-including chemotherapy to treat HIV-related lymphoma to investigate whether protease inhibitor (PI) treatment is associated with infectious complications due to drug interactions with chemotherapeutic agents. We included all HIV patients who received chemotherapy including vincristine for lymphoma at a single referral center in 1999-2010. Neutropenic fever was defined as absolute neutrophil count < 500 cells/microL with body temperature over 38degrees C; and prolonged neutropenia was defined if it persisted over 7 days. CODOX-M/IVAC and Stanford regimens were considered high-risk regimens for prolonged neutropenia. We analyzed 48 cycles of chemotherapy in 17 HIV patients with lymphoma. There were 22 neutropenic fever and 12 febrile prolonged neutropenia events. In multivariate analysis, neutropenic fever was associated with old age and low CD4 cell count, but not with PI use or ritonavir-boosted PI use. Low CD4 cell count and high-risk regimens were associated with febrile prolonged neutropenia. Neutropenic fever and febrile prolonged neutropenia is associated with old age, low CD4 cell count, and high-risk regimens, but not PI use, in HIV patients undergoing chemotherapy including vincristine for lymphoma.
Adult ; Age Factors ; Antineoplastic Agents, Phytogenic/*therapeutic use ; Body Temperature ; CD4 Lymphocyte Count ; Fever/*etiology ; HIV Infections/complications ; Humans ; Lymphoma, AIDS-Related/complications/*drug therapy/pathology ; Male ; Middle Aged ; Multivariate Analysis ; Neutropenia/*etiology ; Retrospective Studies ; Risk Factors ; Vincristine/*therapeutic use

Human immunodeficiency virus (HIV) infection is a risk factor for developing non-Hodgkin's lymphoma. Most acquired immune deficiency syndrome (AIDS)-related lymphomas are high-grade B cell non-Hodgkin's lymphomas. The use of highly active antiretroviral therapy has reduced the incidence of AIDS-related lymphoma. There have been 7 reports of AIDS-related extra-nodal lymphoma in Korea. We report a case of AIDS-related lymphoma detected by MiroCam(R) capsule endoscopy.
Acquired Immunodeficiency Syndrome/*complications/drug therapy/immunology ; Anti-HIV Agents/therapeutic use ; Antiretroviral Therapy, Highly Active ; *Capsule Endoscopes ; HIV Infections/virology ; Humans ; Jejunal Neoplasms/*diagnosis/pathology ; Lymphoma, AIDS-Related/*diagnosis/pathology ; Lymphoma, Large B-Cell, Diffuse/immunology/pathology ; Male ; Middle Aged ; Tomography, X-Ray Computed