International Network for Cancer Treatment and Research, Brussels, Belgium.
Curr Opin Oncol. 2009 Sep;21(5):462-8. doi: 10.1097/CCO.0b013e32832f3dcd.
The center of gravity of the AIDS epidemic has moved - in 2007, 67% of all persons living with HIV infection and 72% of all deaths from AIDS occurred in Africa. The present review focuses on the treatment of an AIDS-defining malignancy, Burkitt lymphoma, since the discovery of the tumor in 1958 to provide a backdrop to the increasing necessity of dealing with AIDS-associated Burkitt lymphoma in Africa.
In Africa, it appears that AIDS-associated Burkitt lymphoma is increasing, but although treatment outcome is presently poor, the demonstration that highly active antiretroviral therapy permits the same treatment results to those in AIDS-unassociated Burkitt lymphoma provides hope for the future.
In the 1960s, the extraordinary response of Burkitt lymphoma to chemotherapy provided considerable encouragement to pioneer oncologists. Within little more than a decade, the most active drugs, the value of combination chemotherapy, and the need for intrathecal treatment, as well as the risk of tumor lysis syndrome had been demonstrated, providing a platform on which further advances could be made in resource-rich countries. Since that time, little progress has been made in Africa, but recent collaborative projects have shown that improved treatment outcome can be achieved at low cost. The impact of the HIV epidemic on the epidemiology and treatment of African Burkitt lymphoma will receive increasing focus in the coming years.
艾滋病疫情的中心已经转移——2007 年，67%的艾滋病毒感染者和 72%的艾滋病死亡病例发生在非洲。本综述重点关注艾滋病定义性恶性肿瘤——伯基特淋巴瘤的治疗，自 1958 年发现该肿瘤以来，为在非洲日益需要处理艾滋病相关伯基特淋巴瘤提供了背景。
在非洲，艾滋病相关伯基特淋巴瘤似乎在增加，但尽管目前治疗结果不佳，但高活性抗逆转录病毒疗法能够实现与艾滋病不相关的伯基特淋巴瘤相同的治疗结果，这为未来带来了希望。
在 20 世纪 60 年代，伯基特淋巴瘤对化疗的惊人反应为先驱肿瘤学家提供了巨大的鼓舞。在不到十年的时间里，最有效的药物、联合化疗的价值以及鞘内治疗的必要性，以及肿瘤溶解综合征的风险都得到了证实，为在资源丰富的国家取得进一步进展提供了平台。自那时以来，非洲几乎没有取得任何进展，但最近的合作项目表明，可以以较低的成本实现更好的治疗效果。在未来几年，艾滋病毒流行对非洲伯基特淋巴瘤的流行病学和治疗的影响将受到越来越多的关注。
