Diamond Catherine, Taylor Thomas H, Im Theresa, Miradi Mohammed, Anton-Culver Hoda
University of California, Irvine Department of Medicine, CA, USA.
Hematol Oncol. 2006 Sep;24(3):139-45. doi: 10.1002/hon.778.
Highly active antiretroviral therapy (HAART) became available in the US in 1996. Using the population-based cancer registry, we identified 233 patients with AIDS-related systemic NHL diagnosed in San Diego or Orange County in 1994-1999, of whom 137 were diagnosed 1996-1999. We performed Kaplan-Meier analyses to compare survival between patients who received HAART at NHL diagnosis or thereafter versus untreated patients and Cox proportional hazard models for adjusted survival. We used logistic regression to determine if concomitant HAART changed the probability of complete response to chemotherapy and the Mann-Whitney U-test to compare the median number of chemotherapy cycles between patients who received HAART during chemotherapy versus those who did not. Among patients diagnosed with NHL in 1996-1999, 40 (29%) were taking HAART at NHL diagnosis. The median survival was three months among patients who did not receive HAART versus 16 months among HAART-treated patients. HAART, chemotherapy, high performance status, and NHL stage < IV were associated with improved survival. Concomitant HAART, completion of > or = 6 chemotherapy cycles, and NHL stage < IV were associated with complete response to chemotherapy. The median number of chemotherapy cycles was five among patients who received HAART concomitant with chemotherapy versus three among untreated patients. We conclude that HAART should be initiated or continued after NHL diagnosis, including during the period of chemotherapy administration.
高效抗逆转录病毒疗法（HAART）于1996年在美国开始应用。利用基于人群的癌症登记系统，我们识别出1994 - 1999年在圣地亚哥或奥兰治县被诊断为艾滋病相关系统性非霍奇金淋巴瘤（NHL）的233例患者，其中137例在1996 - 1999年被诊断。我们进行了Kaplan - Meier分析，以比较在NHL诊断时或之后接受HAART的患者与未治疗患者之间的生存率，并采用Cox比例风险模型进行生存调整。我们使用逻辑回归来确定同时进行的HAART是否改变了化疗完全缓解的概率，并使用Mann - Whitney U检验来比较在化疗期间接受HAART的患者与未接受HAART的患者之间化疗周期的中位数。在1996 - 1999年被诊断为NHL的患者中，40例（29%）在NHL诊断时正在接受HAART。未接受HAART的患者中位生存期为3个月，而接受HAART治疗的患者为16个月。HAART、化疗、良好的身体状况和NHL分期<IV与生存率提高相关。同时进行HAART、完成≥6个化疗周期以及NHL分期<IV与化疗完全缓解相关。在化疗期间接受HAART的患者化疗周期中位数为5个，而未治疗患者为3个。我们得出结论，在NHL诊断后应开始或继续使用HAART，包括在化疗期间。
