|What is the rationale for the difference in chemotherapy dosage for HIV versus non HIV Patients?
Mar 24, 2002
Dr Dezube: Could you explain to me the rationale for the diluted dosage of chemotherapy for HIV versus full strength for non-HIV patients for non-Hodgkin's lymphoma. Would diluted chemotherapy cause the patient to relapse? Also why is 300 micrograms of Neupogen standard for HIV patients versus 480 micrograms in non-HIV NHL patients. Thank you so much for your kind work.
Response from Dr. Dezube
I actually don't like the word "diluted dosage" since it conveys, at least to me, that the chemotherapy is watered down. This is hardly the case. Non-HIV patients should receive "standard dose" of chemotherapy unless there's a good reason for them not to do so. HIV-infected patients should also receive "standard dose" provided they are "reasonably healthy". Occasionally we dose-reduce the chemotherapy by as much as 50% in HIV-infected patients who are "fragile". Although it's hard for me to give a firm definition of whom I would view as fragile, a patient who is confined to bed 100% of the time, with a CD4 count in single digits, and suffering from ongoing pneumocystis pneumonia and CMV retinitis would be such a case (I recently had such a patient). That said, most HIV patients should receive full dose.
In a New England Journal of Medicine article, which I co-authored, we showed that for the more "fragile" HIV-infected patient, half-dose chemotherapy works about as well as full-dose.
In terms of neupogen, I use 300 micrograms for both HIV and non-HIV patients. It works quite well. I use 480 micrograms only in very, very large patients, for example those who are the size of the football players on SuperBowl Sunday. Interestingly enough, HIV-infected patients often respond better to neupogen than HIV-negative patients.
So instead of "diluted" chemotherapy, the proper term is "dose-reduced". Hope this clarifies the situation.
Really Confused and Scared! Obsessing about lymphoma.
Blood in my bowel movements! Help.
- Sinus Infection Could I Have Acute HIV Infection
- Can HIV Be Transmitted Through Picking Your Nose?
- Odds Of Getting AIDS Sex With A Prostitute
- Enlarged Lymph Nodes After Mutual Masturbation Worried I Have HIV
- Jock Itch After Swallowing Cum Sign Of HIV AIDS
- Rectal Bleeding After Lap Dance Worried I Have HIV
This forum is designed for educational purposes only, and experts are not rendering medical, mental health, legal or other professional advice or services. If you have or suspect you may have a medical, mental health, legal or other problem that requires advice, consult your own caregiver, attorney or other qualified professional.
Experts appearing on this page are independent and are solely responsible for editing and fact-checking their material. Neither TheBody.com nor any advertiser is the publisher or speaker of posted visitors' questions or the experts' material.