Diffuse large B cell primary hepatic lymphoma is a rare disease with limited available information regarding treatment strategy. Although the liver contains lymphoid tissue and is an important site for lymphocytes act...Diffuse large B cell primary hepatic lymphoma is a rare disease with limited available information regarding treatment strategy. Although the liver contains lymphoid tissue and is an important site for lymphocytes activation, primary hepatic lymphoma is rare. Host factors make the liver a poor environment for malignant lymphoma development. Its coexistence with human immunodeficiency virus(HIV) infection increases morbidity and mortality risks. Additionally, jaundice increases chances of developing adverse effects from chemotherapy. Here, we report a case of diffuse large B cell primary hepatic lymphoma in a 32-year-old HIV positive man. Due to elevated liver enzyme levels and jaundice, the patient was initially treated with an R-DHAP regimen, which was replaced with an R-CHOP regimen. Restaging images with a positron emission tomography scan after the latest chemotherapy cycle confirmed remission. This is the first report of complete remission of primary hepatic diffuse large B cell lymphoma in an HIV positive patient in the English literature.展开更多
目的分析比较人类免疫缺陷病毒(HIV)阳性与阴性弥漫大B细胞淋巴瘤患者的临床特点及疗效。方法收集博茨瓦纳弗朗西斯敦市仰加奎医院肿瘤内科2012年3月至2015年3月诊治的弥漫大B细胞淋巴瘤患者共71例,其中HIV阳性37例,HIV阴性34例,给予CHO...目的分析比较人类免疫缺陷病毒(HIV)阳性与阴性弥漫大B细胞淋巴瘤患者的临床特点及疗效。方法收集博茨瓦纳弗朗西斯敦市仰加奎医院肿瘤内科2012年3月至2015年3月诊治的弥漫大B细胞淋巴瘤患者共71例,其中HIV阳性37例,HIV阴性34例,给予CHOP方案一线化疗,对两组的临床特点及疗效进行分析。结果与HIV阴性组相比,HIV阳性组B症状发生率高(56.8%vs.29.4%;P=0.020),更容易出现胃肠道(37.8%vs.14.7%;P=0.028)、肝(29.7%vs.9.7%;P=0.027)、肺(27.0%vs.9.7%;P=0.048)浸润。HIV阳性组与HIV阴性组治疗完全缓解率分别为18.9%(7/37)与41.2%(14/34)(P=0.040);客观有效率分别为48.6%(18/37)与70.6%(24/34)(P=0.060)。HIV阳性组化疗后出现贫血、白细胞下降及继发感染比例高于HIV阴性组(均P<0.05)。HIV阳性组中有24例在确诊淋巴瘤前已给予高效价抗逆转录病毒治疗(highly active antiretroviral therapy,HAART)治疗,13例确诊后给予HARRT治疗,其客观有效率分别为41.7%和61.5%(P=0.248)。CD4+细胞数>200/mm3和≤200/mm3患者,其客观有效率分别为71.4%和34.8%(P=0.031)。结论 HIV阳性患者就诊时表现出更强的侵袭性。结合HARRT治疗,CHOP方案可使HIV阳性患者达到类似于HIV阴性患者的客观有效率,但完全缓解率低。HIV阳性组患者HARRT起始治疗时间不影响近期疗效。CD4^+细胞数低是近期疗效不良的预测因素。展开更多
文摘Diffuse large B cell primary hepatic lymphoma is a rare disease with limited available information regarding treatment strategy. Although the liver contains lymphoid tissue and is an important site for lymphocytes activation, primary hepatic lymphoma is rare. Host factors make the liver a poor environment for malignant lymphoma development. Its coexistence with human immunodeficiency virus(HIV) infection increases morbidity and mortality risks. Additionally, jaundice increases chances of developing adverse effects from chemotherapy. Here, we report a case of diffuse large B cell primary hepatic lymphoma in a 32-year-old HIV positive man. Due to elevated liver enzyme levels and jaundice, the patient was initially treated with an R-DHAP regimen, which was replaced with an R-CHOP regimen. Restaging images with a positron emission tomography scan after the latest chemotherapy cycle confirmed remission. This is the first report of complete remission of primary hepatic diffuse large B cell lymphoma in an HIV positive patient in the English literature.
文摘目的分析比较人类免疫缺陷病毒(HIV)阳性与阴性弥漫大B细胞淋巴瘤患者的临床特点及疗效。方法收集博茨瓦纳弗朗西斯敦市仰加奎医院肿瘤内科2012年3月至2015年3月诊治的弥漫大B细胞淋巴瘤患者共71例,其中HIV阳性37例,HIV阴性34例,给予CHOP方案一线化疗,对两组的临床特点及疗效进行分析。结果与HIV阴性组相比,HIV阳性组B症状发生率高(56.8%vs.29.4%;P=0.020),更容易出现胃肠道(37.8%vs.14.7%;P=0.028)、肝(29.7%vs.9.7%;P=0.027)、肺(27.0%vs.9.7%;P=0.048)浸润。HIV阳性组与HIV阴性组治疗完全缓解率分别为18.9%(7/37)与41.2%(14/34)(P=0.040);客观有效率分别为48.6%(18/37)与70.6%(24/34)(P=0.060)。HIV阳性组化疗后出现贫血、白细胞下降及继发感染比例高于HIV阴性组(均P<0.05)。HIV阳性组中有24例在确诊淋巴瘤前已给予高效价抗逆转录病毒治疗(highly active antiretroviral therapy,HAART)治疗,13例确诊后给予HARRT治疗,其客观有效率分别为41.7%和61.5%(P=0.248)。CD4+细胞数>200/mm3和≤200/mm3患者,其客观有效率分别为71.4%和34.8%(P=0.031)。结论 HIV阳性患者就诊时表现出更强的侵袭性。结合HARRT治疗,CHOP方案可使HIV阳性患者达到类似于HIV阴性患者的客观有效率,但完全缓解率低。HIV阳性组患者HARRT起始治疗时间不影响近期疗效。CD4^+细胞数低是近期疗效不良的预测因素。
