Raez L, Cabral L, Cai J P, Landy H, Sfakianakis G, Byrne G E, Hurley J, Scerpella E, Jayaweera D, Harrington W J
Division of Hematology/Oncology, University of Miami School of Medicine/Jackson Memorial Hospital, Florida 33136, USA.
AIDS Res Hum Retroviruses. 1999 May 20;15(8):713-9. doi: 10.1089/088922299310809.
AIDS-related primary central nervous system lymphoma (AIDS PCNSL) is a rapidly fatal disease. Conventional therapeutic modalities offer little and new approaches are needed. Previous work has shown that zidovudine (AZT) in combination with other agents is active in retroviral lymphomas. Epstein-Barr virus (EBV) is detected in tumor tissue and cerebrospinal fluid of AIDS PCNSL patients. In a preliminary in vitro study we found that an Epstein-Barr virus-positive B cell line underwent apoptosis on coculture with AZT. This effect was accentuated by the addition of ganciclovir (GCV). We treated five patients with AIDS PCNSL with a regimen consisting of parenteral zidovudine (1.6 g twice daily), ganciclovir (5 mg/kg twice daily), and interleukin 2 (2 million units twice daily). Four of five had an excellent response. Two patients are alive and free of disease 22 and 13 months later; another responded on two separate occasions, 5 months apart, and the last patient responded with a 70-80% regression of tumor but could not be maintained on therapy owing to myelosuppression. We conclude that parenteral zidovudine, ganciclovir, and interleukin 2 is an active combination for AIDS-related central nervous system lymphoma.
艾滋病相关的原发性中枢神经系统淋巴瘤（AIDS PCNSL）是一种快速致命的疾病。传统治疗方式效果甚微，需要新的治疗方法。先前的研究表明，齐多夫定（AZT）与其他药物联合使用对逆转录病毒淋巴瘤有效。在AIDS PCNSL患者的肿瘤组织和脑脊液中可检测到爱泼斯坦-巴尔病毒（EBV）。在一项初步的体外研究中，我们发现一株EBV阳性B细胞系与AZT共培养时会发生凋亡。添加更昔洛韦（GCV）可增强这种效应。我们用一种由静脉注射齐多夫定（每日两次，每次1.6 g）、更昔洛韦（每日两次，每次5 mg/kg）和白细胞介素2（每日两次，每次200万单位）组成的方案治疗了5例AIDS PCNSL患者。5例中有4例反应良好。2例患者在22个月和13个月后存活且无疾病；另1例在相隔5个月的两次治疗中均有反应，最后1例患者肿瘤消退70 - 80%，但由于骨髓抑制无法继续接受治疗。我们得出结论，静脉注射齐多夫定、更昔洛韦和白细胞介素2联合使用对艾滋病相关的中枢神经系统淋巴瘤是一种有效的治疗组合。
