高效抗逆转录病毒疗法（HAART）可提高HIV相关霍奇金淋巴瘤患者的生存率：一项多中心研究结果

Highly active antiretroviral therapy (HAART) improves survival in HIV-associated Hodgkin's disease: results of a multicenter study.

作者信息

Hentrich M, Maretta L, Chow K U, Bogner J R, Schürmann D, Neuhoff P, Jäger H, Reichelt D, Vogel M, Ruhnke M, Oette M, Weiss R, Rockstroh J, Arasteh K, Mitrou P

机构信息

Department of Hematology/Oncology, Hospital Harlaching, Munich, Germany.

出版信息

Ann Oncol. 2006 Jun;17(6):914-9. doi: 10.1093/annonc/mdl063. Epub 2006 Mar 24.

DOI:10.1093/annonc/mdl063

PMID:16565210

Abstract

BACKGROUND

The purpose of the study was to evaluate the outcome of Hodgkin's disease (HD) in patients infected with the human immunodeficiency virus (HIV) with respect to the use of highly active antiretroviral therapy (HAART).

MATERIALS AND METHODS

This cohort study included patients with HIV-HD diagnosed from June 1984 to February 2004. Patients treated in the pre-HAART era (1984-1996) were compared with those belonging to the HAART era (1997-2004).

RESULTS

Of 66 patients with HIV-HD, 47 (71%) presented with stage III/IV disease and 38 patients (58%) with an AIDS-defining illness. Fifty-nine of 66 patients (89.4%) underwent curative intended chemotherapy. Patients receiving HAART (n = 34) had a significantly better 2-year overall survival (OS) than those not receiving HAART (74% versus 30%, P <0.001). The 2-year OS of HAART-responders was 88% compared with 19% in patients without HAART-response (P = 0.0002). By multivariate analysis patients without HAART had a 5.6-fold higher risk for 3-year mortality [HR 5.6, 95% confidence interval (CI) 2.20-14.26]. Three-year mortality was significantly higher in patients without complete remission (HR 4.40, CI 1.77-10.99), with stage III/IV HD (HR 4.64, CI 1.31-16.49) and with CD4 cells <200/microl (HR 2.69, CI 0.99-7.33).

CONCLUSIONS

Use of HAART significantly improved the overall survival in patients with HIV-HD.

摘要

背景

本研究的目的是评估感染人类免疫缺陷病毒（HIV）的霍奇金淋巴瘤（HD）患者在使用高效抗逆转录病毒治疗（HAART）方面的预后。

材料与方法

这项队列研究纳入了1984年6月至2004年2月期间诊断为HIV-HD的患者。将HAART治疗时代之前（1984 - 1996年）接受治疗的患者与HAART治疗时代（1997 - 2004年）的患者进行比较。

结果

66例HIV-HD患者中，47例（71%）为Ⅲ/Ⅳ期疾病，38例（58%）患有艾滋病定义疾病。66例患者中有59例（89.4%）接受了根治性化疗。接受HAART治疗的患者（n = 34）的2年总生存率（OS）明显高于未接受HAART治疗的患者（74%对30%，P <0.001）。HAART治疗有反应者的2年总生存率为88%，而无HAART治疗反应者为19%（P = 0.0002）。多因素分析显示，未接受HAART治疗的患者3年死亡率高5.6倍[风险比（HR）5.6，95%置信区间（CI）2.20 - 14.26]。未完全缓解的患者（HR 4.40，CI 1.77 - 10.99）、患有Ⅲ/Ⅳ期HD的患者（HR 4.64，CI 1.31 - 16.49）以及CD4细胞<200/μl的患者（HR 2.69，CI 0.99 - 7.33）的3年死亡率明显更高。