Department of Medicine and Division of Hematology and Oncology, The Warren Alpert Medical School of Brown University, The Miriam Hospital, Providence, Rhode Island, USA.
Am J Hematol. 2012 Mar;87(3):330-3. doi: 10.1002/ajh.22275. Epub 2012 Feb 3.
In HIV-positive patients with non-Hodgkin lymphoma (NHL), no benefit of adding rituximab to chemotherapy was seen in a randomized controlled trial (RCT). We performed a meta-analysis of prospective studies to ascertain outcomes in HIV-positive NHL patients treated with chemotherapy (chemo) versus rituximab and chemo (R-chemo). A literature search through September 2011 was performed using the key search "(HIV OR AIDS) AND lymphoma". The main outcomes were overall response rate (ORR), complete response rate (CRR) and 2-year overall survival (OS) and are reported as non-adjusted odds ratio (OR). We identified 15 prospective studies including 1,060 HIV-positive NHL patients, 675 treated with chemo and 385 with R-chemo. There was a higher proportion of HAART in R-chemo patients (82% vs. 68%; p < 0.01) but there were no differences in proportion of patients with advanced stage or high/high-intermediate age-adjusted International Prognostic Index (aaIPI) scores. Meta-analysis showed the OR for ORR, CRR and 2-year OS in patients treated with R-chemo was 1.39 (95% CI 0.79-2.47; p = 0.26), 1.66 (95% CI 0.98-2.82; p = 0.06) and 2.19 (95% CI 1.68-2.86; p < 0.001), respectively. HIV-positive lymphoma patients treated with R-chemo had higher odds for CR and 2-year OS when compared to chemo but also had a higher proportion of HAART usage.
在 HIV 阳性的非霍奇金淋巴瘤（NHL）患者中，一项随机对照试验（RCT）并未显示利妥昔单抗联合化疗可带来获益。我们对前瞻性研究进行了荟萃分析，以确定接受化疗（chemo）与利妥昔单抗和化疗（R-chemo）治疗的 HIV 阳性 NHL 患者的结局。通过关键搜索词“（HIV 或 AIDS）和淋巴瘤”进行了截至 2011 年 9 月的文献检索。主要结局是总缓解率（ORR）、完全缓解率（CRR）和 2 年总生存率（OS），并报告为未经调整的比值比（OR）。我们共确定了 15 项前瞻性研究，包括 1060 例 HIV 阳性 NHL 患者，其中 675 例接受了 chemo 治疗，385 例接受了 R-chemo 治疗。R-chemo 组中接受高效抗逆转录病毒治疗（HAART）的患者比例更高（82% vs. 68%；p < 0.01），但晚期疾病和高/中高危年龄调整国际预后指数（aaIPI）评分较高的患者比例无差异。荟萃分析显示，接受 R-chemo 治疗的患者的 ORR、CRR 和 2 年 OS 的 OR 分别为 1.39（95%CI 0.79-2.47；p = 0.26）、1.66（95%CI 0.98-2.82；p = 0.06）和 2.19（95%CI 1.68-2.86；p < 0.001）。与 chemo 相比，接受 R-chemo 治疗的 HIV 阳性淋巴瘤患者的 CR 和 2 年 OS 几率更高，但也有更高比例的患者使用了 HAART。
