艾滋病相关伯基特淋巴瘤10例患者临床特征分析

Clinical analysis of 10 cases of AIDS related Burkitt lymphoma

目的探讨AIDS相关伯基特淋巴瘤的临床特点,提高临床医生对该病的认识。方法回顾性分析云南省传染病医院感染二科2004年1月—2020年12月住院的10例AIDS相关伯基特淋巴瘤的临床特点、实验室检查、治疗方案和临床转归。结果10例患者男女比为9:1,患者年龄21~55岁,平均36.4岁。7例患者以局部肿块为首发症状,1例以阴道大量出血伴血小板减少为首发症状,2例合并中枢神经系统侵犯,10例美国东部肿瘤协作组体能状况评分均≥2分。就诊时10例患者CD4+T细胞计数为107~308个/μl,平均225.2个/μl,9例患者病情分期为IV期,10例危险分层均为高危组。3例患者化疗联合抗病毒治疗后获得完全缓解,1例接受化疗联合抗病毒治疗序贯造血干细胞移植治疗后获得完全缓解,2例难治性病例接受化疗联合抗病毒治疗序贯造血干细胞移植治疗期间死于相关并发症。结论AIDS相关伯基特淋巴瘤临床表现复杂多样,病情进展迅速,易多部位侵犯。及早诊断,在积极抗病毒治疗的同时及时启动高强度化疗,高危患者有条件者应行造血干细胞移植,可能对提高生存期有帮助。

Objective To explore the clinical characteristics of AIDS related Burkitt lymphoma and improve the clinician’s understanding of this disease. Methods Clinical characteristics, laboratory examinations, treatment regimens and clinical outcomes of 10 patients with AIDS related Burkitt lymphoma who were hospitalized in the Second Department of Infectious Diseases at Yunnan Provincial Infectious Disease Hospital from January 2004 to December 2020 were retrospectively analyzed. Results Among 10 patients, the male/female ratio was 9:1, their median age was 36.4 years(range 21-55 years). For first symptom, 7 patients had local masses, 1 patient had massive vaginal bleeding with thrombocytopenia, and 2 patients were complicated with central nervous system invasion. Eastern Cooperative Oncology Group performance status score was higher than or equal to 2 points in 10 patients.The average CD4+ T cell count of 10 patients at admission was 225.2 cells/μl(range 107-308 cells/μl). The disease condition of 9 patients was graded as stage IV, and the risk of 10 patients was stratified as high risk. Three patients achieved complete remission after chemotherapy combined with HARRT. One patient achieved complete remission after chemotherapy combined with HARRT and sequential hematopoietic stem cell transplantation. Two refractory patients died of related complications during chemotherapy combined with HARRT and sequential hematopoietic stem cell transplantation. Conclusions The clinical manifestations of AIDS related Burkitt lymphoma are complex and diverse, with rapid progression and easy invasions at multiple sites. Early diagnosis, timely initiation of high-intensity chemotherapy with HARRT, and conditional hematopoietic stem cell transplantation in high-risk patients may be helpful for prolonging survival time.