艾滋病相关非霍奇金淋巴瘤38例治疗及预后分析

Treatment and Prognosis of AIDS Patients with Non-Hodgkin Lymphoma:An Analysis of 38 Cases

[目的]探讨艾滋病相关非霍奇金淋巴瘤的临床特点、预后。[方法]38例化疗疗程大于2程,随访日期大于1年及以上的艾滋病合并非霍奇金淋巴瘤患者入组,分析患者的治疗方法及预后情况。[结果]38例中有30例患者在化疗期间出现Ⅲ~Ⅳ度骨髓抑制,只有8例患者按原定化疗剂量完成化疗,有6例患者因化疗相关毒副作用使用分段化疗(CR率类似)且OS及EFS、OS率无明显差异。5例在化疗期间仍使用NNRTIs与PIs行HAART治疗的患者均出现反复的IV度骨髓抑制及肝功能损害。38例患者中有16例CR,4例CRu,10例PR,3例SD,5例PD。38例患者生存期最长47个月,最短3个月,中位生存时间16个月。[结论]艾滋病相关非霍奇金淋巴瘤患者普通化疗方案耐受度差,且抗感染治疗及抗病毒治疗与化疗药物间有明显相互作用,使用整合酶抑制剂和分段化疗可提高患者的耐受度和缓解率。

[Objective]To investigate the clinical features and prognosis of AIDS patients with non-Hodgkin lymphoma.[Methods]Thirty-eight AIDS patients with non-Hodgkin's lymphoma,who had received more than 2 cycle of chemotherapy and at least one year of followed-up were enrolled,the treatment and prognosis of patients were analyzed.[Results]Among all recruited patients,30 cases showed Ⅲ~Ⅳdegree myelosuppression during chemotherapy,and only 8 patients completed full-dose chemotherapy.Six patients received section chemotherapy because of side effects related to the chemotherapy;they had similar CR rate,and had no significant differences in OS,EFS and OS rate,compared with those in patients completing full-dose chemotherapy.Five patients who continued to receive HAART including NNRTIs and PIs during chemotherapy,had repeatedⅣdegree myelosuppression and liver function damage.There were 16 CR,4 CRu,10 PR,3 SD and 5 PD in all 38 patients.The survival time ranged from 3 to 47 months with a median survival time of 16 months.[Conclusion]The tolerance of chemotherapy regimens is poor in AIDS patients with non-Hodgkin's lymphoma.Considering significant interactions between anti-infection drug,antiviral drug and chemotherapy drugs,combination of the integrase inhibitors and staging chemotherapy may improve the patient's tolerance and remission rate.