Djunic Irena, Jevtovic Djordje Ljubomir, Ranin Jovan, Salemovic Dubravka, Tomin Dragica, Mihaljevic Biljana
Institute for Haematology, Clinical Center of Serbia, University of Belgrade, School of Medicine, Koste Todorovica 2, Belgrade, Serbia.
Biomed Pharmacother. 2008 Jan;62(1):12-5. doi: 10.1016/j.biopha.2007.05.012. Epub 2007 Jun 19.
The majority of patients with AIDS-related non-Hodgkin's lymphoma (ARL) present with advanced disease, aggressive histological type, B-symptoms, and often with an extranodal localization. The prognosis is generally poor. The use of highly active antiretroviral therapy (HAART), in combination with chemotherapy, has improved the outcome of ARL.
The aims of this study were to detect prognostic factors for patients with ARL and estimate efficacy of concomitant chemotherapy and HAART on overall survival (OS) of these patients. Also, two different chemotherapy regimens have been tested: low dose (ld) mBACOD and CHOP.
The study series involved 28 patients with ARL treated at the Clinical Center of Serbia in Belgrade during the period 1996-2006. Twenty-six patients had an aggressive type of lymphoma while 2 had an indolent type. Nineteen patients were treated with chemotherapy, 10 with ld mBACOD and 9 with CHOP. Concomitant HAART and chemotherapy were used in 14 patients.
This study demonstrated that significant factors for OS in patients with ARL were the high International Prognostic Index (P=0.019), previous AIDS event (P=0.04), aggressive histological type of NHL (P=0.007) and extranodal disease (P=0.04). The usage of concomitant HAART and chemotherapy had significant effect on median survival (90 months), compared with chemotherapy alone (10 months) (P=0.0002). The patients treated with CHOP had a better response than patients treated with ld mBACOD, but this difference was not significant.
Our data suggest that aggressive presentation of ARL implicates the need not only for more intensive chemotherapy regimens, but the concomitant usage of HAART, which should result in higher rates of OS in ARL patients.
大多数艾滋病相关非霍奇金淋巴瘤（ARL）患者就诊时已处于疾病晚期，组织学类型侵袭性强，有B症状，且常伴有结外病变。总体预后通常较差。高效抗逆转录病毒治疗（HAART）联合化疗改善了ARL的治疗结果。
本研究旨在检测ARL患者的预后因素，并评估联合化疗和HAART对这些患者总生存期（OS）的疗效。此外，还测试了两种不同的化疗方案：低剂量（ld）mBACOD和CHOP。
研究系列包括1996年至2006年期间在贝尔格莱德的塞尔维亚临床中心接受治疗的28例ARL患者。26例患者为侵袭性淋巴瘤，2例为惰性淋巴瘤。19例患者接受化疗，10例采用ld mBACOD方案，9例采用CHOP方案。14例患者同时使用HAART和化疗。
本研究表明，ARL患者OS 的显著影响因素为高国际预后指数（P = 0.019）、既往艾滋病事件（P = 0.04）、NHL侵袭性组织学类型（P = 0.007）和结外病变（P = 0.04）。与单纯化疗（10个月）相比，联合使用HAART和化疗对中位生存期有显著影响（90个月）（P = 0.0002）。接受CHOP方案治疗的患者比接受ld mBACOD方案治疗的患者反应更好，但差异不显著。
我们的数据表明，ARL的侵袭性表现不仅意味着需要更强化的化疗方案，还需要同时使用HAART，这应能提高ARL患者的OS率。
