Jacobson Caron A, Abramson Jeremy S
. Dana-Farber Cancer Institute, Boston, MA 02215, USA.
Adv Hematol. 2012;2012:507257. doi: 10.1155/2012/507257. Epub 2012 Jan 5.
Patients with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) are at increased risk for developing Hodgkin's lymphoma (HL), a risk that has not decreased despite the success of combination antiretroviral therapy (cART) in the modern era. HIV-associated HL (HIV-HL) differs from HL in non-HIV-infected patients in that it is nearly always associated with Epstein-Barr virus (EBV) and more often presents with high-risk features of advanced disease, systemic "B" symptoms, and extranodal involvement. Before the introduction of cART, patients with HIV-HL had lower response rates and worse outcomes than non-HIV-infected HL patients treated with conventional chemotherapy. The introduction of cART, however, has allowed for the delivery of full-dose and dose-intensive chemotherapy regimens with improved outcomes that approach those seen in non-HIV infected patients. Despite these significant advances, HIV-HL patients remain at increased risk for treatment-related toxicities and drug-drug interactions which require careful attention and supportive care to insure the safe administration of therapy. This paper will address the modern diagnosis, risk stratification, and therapy of HIV-associated HL.
人类免疫缺陷病毒/获得性免疫缺陷综合征（HIV/AIDS）患者发生霍奇金淋巴瘤（HL）的风险增加，尽管现代联合抗逆转录病毒疗法（cART）取得了成功，但这种风险并未降低。与未感染HIV的HL患者相比，HIV相关HL（HIV-HL）的不同之处在于，它几乎总是与爱泼斯坦-巴尔病毒（EBV）相关，并且更常表现为晚期疾病的高危特征、全身性“B”症状和结外受累。在引入cART之前，HIV-HL患者的缓解率低于接受传统化疗的未感染HIV的HL患者，预后也更差。然而，cART的引入使得能够实施全剂量和剂量密集型化疗方案，其改善后的预后接近未感染HIV患者的情况。尽管取得了这些重大进展，但HIV-HL患者发生治疗相关毒性和药物相互作用的风险仍然增加，这需要密切关注并给予支持性护理，以确保安全给药。本文将探讨HIV相关HL的现代诊断、风险分层和治疗。
