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Detrimental clinical interaction between ritonavir-boosted protease inhibitors and vinblastine in HIV-infected patients with Hodgkin's lymphoma

Cingolani, Antonellaa; Torti, Lorenzab; Pinnetti, Carmelaa; Donati, Katleen de Gaetanoa; Murri, Ritaa; Tacconelli, Evelinaa; Larocca, Luigi Mariac; Teofili, Lucianab

doi: 10.1097/QAD.0b013e32833db989
Research Letters

In order to analyze the clinical relevance of the pharmacokinetic interactions between vinblastine and antiretrovirals described in literature, we evaluated all HIV-infected patients with Hodgkin's lymphoma treated with vinblastine-containing regimens and combination antiretroviral therapy, in a single clinical center. The use of protease inhibitors was independently associated with WHO grade III–IV neutropenia. Moreover, an inverse correlation between dosage of ritonavir and mean nadir neutrophil count was found. The concomitant administration of vinblastine-containing chemotherapy regimens with protease inhibitors can lead to higher levels of neutropenia than those of different classes of drugs such as nonnucleoside reverse transcriptase inhibitors or integrase inhibitors.

aInstitute of Infectious Diseases, Italy

bInstitute of Hematology, Italy

cInstitute of Histopathology, Catholic University, Rome, Italy.

Received 24 March, 2010

Revised 24 June, 2010

Accepted 29 June, 2010

Correspondence to Antonella Cingolani, MD, Institute of Infectious Diseases, Catholic University, Rome, Italy. Tel: +39 06 30155385; fax: +39 06 3054519; e-mail:

© 2010 Lippincott Williams & Wilkins, Inc.