Nair R, Prabhash K, Sengar M, Bakshi A, Gujral S, Gupta S, Parikh P
Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India.
Ann Oncol. 2007 Jul;18(7):1243-5. doi: 10.1093/annonc/mdm107. Epub 2007 Apr 13.
Various malignancies and cytotoxic chemotherapy have been proposed to increase the risk of reactivation of tuberculosis. Available literature to support this observation is still conflicting. There is scarcity of data from countries with rampant tubercular infection, such as India, in this regard.
In the present retrospective analysis, patients with high-grade non-Hodgkin's lymphoma with past history of tuberculosis and have had adequate antitubercular therapy were identified from a Lymphoma Group study. These patients were followed up during cytotoxic chemotherapy and later to assess the risk of reactivation.
A cohort of eight patients with past history of tuberculosis was selected from 141 patients of high-grade non-Hodgkin's lymphoma. The median age was 33.5 years (range, 24-53 years). Median duration between completion of antitubercular treatment and diagnosis of lymphoma was 5 years (range, 1.5-10 years). All patients received cyclical cytotoxic chemotherapy. The median duration of follow up after completion of chemotherapy was 5 years (range, 10 months to 5 years). None of these patients developed reactivation of tuberculosis.
Cyclical chemotherapy for non-Hodgkin's lymphoma does not lead to reactivation of tuberculosis.
多种恶性肿瘤及细胞毒性化疗已被认为会增加结核病复发的风险。支持这一观察结果的现有文献仍存在矛盾。在这方面,来自结核病感染猖獗的国家(如印度)的数据匮乏。
在本次回顾性分析中,从一项淋巴瘤组研究中确定了有结核病既往史且接受过充分抗结核治疗的高级别非霍奇金淋巴瘤患者。在细胞毒性化疗期间及之后对这些患者进行随访,以评估复发风险。
从141例高级别非霍奇金淋巴瘤患者中选出8例有结核病既往史的患者。中位年龄为33.5岁(范围24 - 53岁)。抗结核治疗完成至淋巴瘤诊断的中位间隔时间为5年(范围1.5 - 10年)。所有患者均接受了周期性细胞毒性化疗。化疗完成后的中位随访时间为5年(范围10个月至5年)。这些患者中无一例发生结核病复发。
非霍奇金淋巴瘤的周期性化疗不会导致结核病复发。