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OBJECTIVE To evaluate the efficacy and toxicity of vincristine and bleomycin when used in combination to treat patients with progressive Kaposi's sarcoma. METHODS A retrospective case notes review. METHODS The departments of Immunology and Genito-Urinary Medicine, St Mary's Hospital, London, UK. METHODS All patients presenting with progressive Kaposi's sarcoma and requiring chemotherapy between January 1987 and January 1990, who had received no previous systemic chemotherapy. METHODS Treatment with vincristine (2 mg) and bleomycin (30 mg, 18 h infusion), or vinblastine (2.5-5.0 mg) if peripheral neuropathy developed. Treatment with zidovudine and prophylaxis of opportunistic infections where indicated. METHODS Response, toxicity and survival. RESULTS Overall, patients had a poor prognosis: 33 out of 46 (72%) had had a previous opportunistic infection, had a mean CD4 count of 144 x 10(6) (20 out of 46 tested) and a mean Karnofsky index of 75.4. They received a median of five cycles of therapy: a partial response was achieved in twenty-six patients (57%), disease progression was halted in a further 16 (35%), while disease progression continued in four (9%) despite therapy; there were no complete responders. Mean duration of response was 2 months (s.d., 1.26 months), survival was 8 months (s.d., 6.7 months) from start of therapy and 17 months (s.d., 8.9. months) from first AIDS diagnosis. On multivariate analysis the best predictor of mortality was the presence of previous opportunistic infection (P = 0.00653). Side-effects were minimal in comparison with other studies. The most common side-effect, in 13 cases (28%), was peripheral neuropathy, which may in part represent the prevalence of HIV neuropathy or remain as background. Haematological toxicity was uncommon. CONCLUSIONS Treatment for HIV-related Kaposi's sarcoma in advanced HIV disease is becoming more necessary as disease profiles change. Conventional chemotherapy regimens for malignancy are not well tolerated in these patients and may not be indicated. This regimen is effective and has low toxicity in AIDS patients. Non-responders should be considered for more intensive regimens.
M M Gompels, and
A Hill, and
P Jenkins, and
B Peters, and
D Tomlinson, and
J R Harris, and
S Stewart, and
A J Pinching, and
A J Munro
April 1993,
AIDS (London, England),
M M Gompels, and
A Hill, and
P Jenkins, and
B Peters, and
D Tomlinson, and
J R Harris, and
S Stewart, and
A J Pinching, and
A J Munro
February 1996,
The British journal of dermatology,
M M Gompels, and
A Hill, and
P Jenkins, and
B Peters, and
D Tomlinson, and
J R Harris, and
S Stewart, and
A J Pinching, and
A J Munro
November 1996,
International journal of dermatology,
M M Gompels, and
A Hill, and
P Jenkins, and
B Peters, and
D Tomlinson, and
J R Harris, and
S Stewart, and
A J Pinching, and
A J Munro
December 1992,
AIDS (London, England),
M M Gompels, and
A Hill, and
P Jenkins, and
B Peters, and
D Tomlinson, and
J R Harris, and
S Stewart, and
A J Pinching, and
A J Munro
January 1990,
Annals of oncology : official journal of the European Society for Medical Oncology,
M M Gompels, and
A Hill, and
P Jenkins, and
B Peters, and
D Tomlinson, and
J R Harris, and
S Stewart, and
A J Pinching, and
A J Munro
August 1990,
American journal of clinical oncology,
M M Gompels, and
A Hill, and
P Jenkins, and
B Peters, and
D Tomlinson, and
J R Harris, and
S Stewart, and
A J Pinching, and
A J Munro
October 1996,
Journal of chemotherapy (Florence, Italy),
M M Gompels, and
A Hill, and
P Jenkins, and
B Peters, and
D Tomlinson, and
J R Harris, and
S Stewart, and
A J Pinching, and
A J Munro
March 1979,
The British journal of radiology,
M M Gompels, and
A Hill, and
P Jenkins, and
B Peters, and
D Tomlinson, and
J R Harris, and
S Stewart, and
A J Pinching, and
A J Munro
January 1991,
Dermatologica,
M M Gompels, and
A Hill, and
P Jenkins, and
B Peters, and
D Tomlinson, and
J R Harris, and
S Stewart, and
A J Pinching, and
A J Munro
January 1979,
Cutis,
