A retrospective cohort study describing chemotherapy-induced peripheral neuropathy in Non-Hodgkin lymphoma patients treated with EPOCH ± R: does HIV status matter?

• Published in: Leukemia & lymphoma Vol. 65; no. 8; p. 1110
• Main Authors: McNally, Gretchen A, Aossey, Connor M, Wiczer, Tracy, Sinnott, Loraine T, Lustberg, Mark, Baiocchi, Robert A, Lustberg, Maryam
• Format: Journal Article
• Language: English
• Published: United States 01.08.2024
• Subjects: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Cyclophosphamide - adverse effects; Cyclophosphamide - therapeutic use; Doxorubicin - adverse effects; Doxorubicin - therapeutic use; Etoposide - administration & dosage; Etoposide - adverse effects; Etoposide - therapeutic use; Female; HIV Infections - complications; HIV Infections - drug therapy; Humans; Incidence; Lymphoma, Non-Hodgkin - complications; Lymphoma, Non-Hodgkin - drug therapy; Lymphoma, Non-Hodgkin - epidemiology; Male; Middle Aged; Peripheral Nervous System Diseases - chemically induced; Peripheral Nervous System Diseases - diagnosis; Peripheral Nervous System Diseases - epidemiology; Prednisone - adverse effects; Prednisone - therapeutic use; Retrospective Studies; Rituximab - administration & dosage; Rituximab - adverse effects; Vincristine - adverse effects; Vincristine - therapeutic use; vincristine; HIV; Chemotherapy-induced peripheral neuropathy; EPOCH ± R; lymphoma
• ISSN: 1029-2403
• DOI: 10.1080/10428194.2024.2340051

The frontline immuno-chemotherapy regimen for HIV-associated non-Hodgkin Lymphoma is dose-adjusted EPOCH ± R (etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab). Chemotherapy-induced peripheral neuropathy (CIPN), caused by vincristine, is a common adverse effect of EPOCH ± R, negatively impacting long-term patient outcomes. The primary objective of this study was to determine the incidence of CIPN, stratified by HIV status, in patients treated with EPOCH ± R. A retrospective cohort study at a tertiary referral comprehensive cancer center evaluated patients treated with EPOCH ± R from 2011 to 2018. The final sample included 27 patients with HIV compared to 279 without HIV (total  = 306). Overall, the incidence of CIPN was 29.4% (  = 90), including 5 with HIV (18.5%) and 85 without HIV (30.5%). Propensity scores were used to match patients by HIV status. Although no relationship was found between HIV status and neuropathy, CIPN affects too many undergoing treatments for lymphoma, supporting future investigations to minimize toxicities.