HIV感染继发淋巴瘤的临床治疗方案探讨——附HIV感染继发罕见灰区淋巴瘤案例分析1例

The Clinical treatment strategy of HIV-related lymphoma: case analysis of HIV-related gray zone lymphoma

目的探讨HIV感染继发淋巴瘤的有效治疗方案。方法对收治的1名以脊髓压迫为首发症状的HIV感染继发罕见灰区淋巴瘤患者,以3TC＋AZT＋NVP标准方案抗逆转录治疗同时采用长春地辛4 mg×1 d、环磷酰胺600 mg×1 d、地塞米松10 mg×3 d减瘤化疗方案治疗,分析临床疗效并探讨相关临床治疗方案。结果该患者接受紧急的减低剂量的化疗后,肿瘤迅速缩小,基础疾病及并发症迅速改善;但停药后肿瘤快速复发,患者最终放弃治疗。结论化疗同时联合抗逆转录病毒治疗可能是治疗危重的HIV相关灰区淋巴瘤的有效手段。

Objective To generate efficacious therapeutic plans for a patient suffered from HIV-related B-cell lymphoma and to review the related papers. Methods One HIV-related gray zone lymphoma patient,with spinal cord compression being the first symptom,received chemotherapy（ Vindesine 4 mg/d d1,Cyclophosphamide 600 mg/d d1,Dexamethasone 10 mg/d d1-3） to reduce tumor-burden. The clinical data of the patient were analyzed to provide valuable references in the treatment of these critically ill patients of HIV-associated lymphoma. Results After an emergency chemotherapy,tumor regressed and complications were swiftly controlled. However,the tumor relapsed soon after ceasing the treatment and,unfortunately the patient refused further treatment. Conclusion Chemotherapy combined with antiretroviral therapy may be an effective treatment strategy for the critically ill patients suffering from HIV-associated lymphoma.