Sparano Joseph A
Albert Einstein College of Medicine, Department of Oncology, Montefiore Medical Center, Weiler Division, Bronx, New York 10461, USA.
Curr Opin Oncol. 2007 Sep;19(5):458-63. doi: 10.1097/CCO.0b013e3282c8c835.
The aim of this article is to review key reports regarding the biology and management of HIV-associated lymphoma during the past year.
The use of highly active antiretroviral therapy (HAART) has been associated with a reduced risk of primary cerebral and systemic non-Hodgkin's lymphoma, a stable or slightly increased risk of Hodgkin's lymphoma, and improved prognosis for those who develop HIV-associated non-Hodgkin's lymphoma or Hodgkin's lymphoma. Emerging evidence suggests that patients with HIV-associated lymphoma should be treated in a similar manner as immunocompetent patients with the same disease, especially if the CD4 count is 50-100 cells/mul or higher. Use of the anti-CD20 monoclonal antibody rituximab in combination with chemotherapy appears to result in improved control of B-cell lymphoma, but may come at the expense of an increased risk of bacterial and viral infections.
Although the evidence currently supports an aggressive and curative approach for the management of HIV-associated lymphoma, clinicians must be vigilant about implementing infection prophylaxis and promptly recognizing, diagnosing, and treating bacterial, parasitic, fungal, and viral infections that may occur as a consequence of therapy.
本文旨在回顾过去一年中有关HIV相关淋巴瘤生物学特性及治疗的关键报告。
高效抗逆转录病毒疗法（HAART）的使用与原发性脑和全身性非霍奇金淋巴瘤风险降低、霍奇金淋巴瘤风险稳定或略有增加相关，且对于发生HIV相关非霍奇金淋巴瘤或霍奇金淋巴瘤的患者，其预后有所改善。新出现的证据表明，HIV相关淋巴瘤患者应与患有相同疾病的免疫功能正常患者接受相似的治疗，尤其是当CD4细胞计数为50-100个/微升或更高时。抗CD20单克隆抗体利妥昔单抗与化疗联合使用似乎能改善B细胞淋巴瘤的控制，但可能会增加细菌和病毒感染的风险。
尽管目前的证据支持对HIV相关淋巴瘤采取积极的治愈性治疗方法，但临床医生必须警惕实施感染预防措施，并及时识别、诊断和治疗因治疗可能出现的细菌、寄生虫、真菌和病毒感染。
