von Gunten C F, Von Roenn J H
Northwestern University, Chicago, Illinois.
Curr Opin Oncol. 1992 Oct;4(5):894-9. doi: 10.1097/00001622-199210000-00012.
As patients with human immunodeficiency virus infection live longer because of better antiretroviral therapy and infection prophylaxis, the incidence of non-Hodgkin's lymphoma has increased. The risk increases inversely with CD4 count--the most widely used surrogate marker for progressive immune suppression. Zidovudine itself does not appear to be a risk factor. Patients frequently present with extranodal advanced disease. The central nervous system is the primary site in 10% to 20% of cases. Important prognostic factors are performance status, a prior history of acquired immunodeficiency syndrome, and bone marrow involvement. Therapy is complicated by underlying immunosuppression, opportunistic infection, and poor bone marrow reserve. Progress has been made using colony-stimulating factors and less intensive chemotherapy regimens in systemic non-Hodgkin's lymphoma. Treatment of primary central nervous system lymphoma with radiation therapy has not improved survival.
随着人类免疫缺陷病毒感染患者因更好的抗逆转录病毒疗法和感染预防措施而寿命延长，非霍奇金淋巴瘤的发病率有所上升。风险与CD4细胞计数呈负相关，CD4细胞计数是用于评估进行性免疫抑制的最广泛使用的替代标志物。齐多夫定本身似乎不是一个风险因素。患者常表现为结外晚期疾病。中枢神经系统是10%至20%病例的主要发病部位。重要的预后因素包括体能状态、获得性免疫缺陷综合征病史和骨髓受累情况。由于存在潜在的免疫抑制、机会性感染和骨髓储备不佳，治疗变得复杂。在系统性非霍奇金淋巴瘤中，使用集落刺激因子和强度较低的化疗方案已取得进展。采用放射治疗原发性中枢神经系统淋巴瘤并未提高生存率。
