Sharma A, Bajpai J, Raina V, Mohanti B K
Department of Medical Oncology, Dr BRA IRCH, AIIMS, New Delhi, India.
Indian J Cancer. 2010 Jan-Mar;47(1):35-9. doi: 10.4103/0019-509X.58857.
To analyze clinical features and survival in HIV-associated non-Hodgkin lymphoma (NHL) cases registered at Dr BRA Institute Rotary Cancer Hospital of AIIMS, New Delhi.
We have retrospectively reviewed records of NHL patients registered, from January 2003 to July 2007 to analyze HIV-associated NHL.
Seven cases of HIV-associated NHL cases were identified. Age range was 14-56 years. Five were males. Baseline performance status (ECOG-PS) was >I in 6. Mean LDH was 409 U/L. Mean hemoglobin was 10.5 g% and mean CD4 count was 243/mm3 (range 18-454). Three cases had nodal lymphoma and four had extra nodal lymphoma. No primary CNS (PCNSL) lymphoma was seen. All patients were of advanced stages and of intermediate to high-risk group based on international prognostic index (IPI). Six cases had high-grade NHL. None had CNS involvement. Five had B symptoms. HIV infection was diagnosed as part of NHL work-up in five patients. All patients received HAART. All were planned for chemotherapy with CNS prophylaxis. Protocols used were CVP, CHOP, R-CHOP or MCP-842. One patient received IFRT.
One patient achieved complete response (CR) and continues to be disease free, with 4.5 years of follow-up. Three cases achieved partial response (PR) and 2 had progressive disease (PD). Currently, three patients are on follow-up.
These NHL are of higher grade and advanced stage. Response and tolerance to chemotherapy is poor. Appropriate supportive care and CNS prophylaxis might improve outcome. We need to improve epidemiological data collection system in this part of world. With HAART, the goal of therapy is durable CR rather than palliation.
分析在新德里全印医学科学研究所BRA Rotary癌症医院登记的HIV相关非霍奇金淋巴瘤（NHL）病例的临床特征和生存情况。
我们回顾性分析了2003年1月至2007年7月登记的NHL患者记录，以分析HIV相关NHL。
共确定7例HIV相关NHL病例。年龄范围为14至56岁。男性5例。6例患者的基线体能状态（ECOG-PS）>1。平均乳酸脱氢酶为409 U/L。平均血红蛋白为10.5 g%，平均CD4细胞计数为243/mm³（范围为18至454）。3例为结内淋巴瘤，4例为结外淋巴瘤。未发现原发性中枢神经系统（PCNSL）淋巴瘤。根据国际预后指数（IPI），所有患者均处于晚期且为中高危组。6例为高级别NHL。均无中枢神经系统受累。5例有B症状。5例患者在NHL检查过程中被诊断出HIV感染。所有患者均接受高效抗逆转录病毒治疗（HAART）。所有患者均计划接受化疗并进行中枢神经系统预防。使用的方案为CVP、CHOP、R-CHOP或MCP-842。1例患者接受了调强适形放疗（IFRT）。
1例患者达到完全缓解（CR），在4.5年的随访中持续无病。3例患者达到部分缓解（PR），2例病情进展（PD）。目前，3例患者正在接受随访。
这些NHL级别较高且处于晚期。化疗反应和耐受性较差。适当的支持治疗和中枢神经系统预防可能会改善预后。我们需要改进世界这一地区的流行病学数据收集系统。通过HAART，治疗目标是持久的CR而非姑息治疗。
