Levine Alexandra M
City of Hope National Medical Center, Duarte, CA, USA.
Hematology. 2012 Apr;17 Suppl 1:S87-9. doi: 10.1179/102453312X13336169155934.
World-wide, approximately 25% of all human malignancies are caused by infectious organisms, including approximately 10% of cancers occurring in resource rich areas of the world. While some of these disorders are more likely to be seen in patients with underlying immunodeficiency, this is not a requisite for development of malignancy, and most patients, in fact, are not immune-suppressed at the time of diagnosis. In considering hematologic malignancies, several organisms have been implicated in disease etiology. These organisms include Human Herpesvirus 8 (HHV8/KSHV), which is linked to primary effusion lymphoma and to multicentric Castleman s disease, as well as to development of Kaposi's sarcoma; Epstein Barr Virus (EBV) which has been associated with Burkitt lymphoma and nasal T cell lymphoma, among others; Human T lymphotrophic virus type I (HTLV 1), which is associated with Adult T cell leukemia/lymphoma (ATLL); Hepatitis C virus, associated with splenic marginal and other lymphomas; and Helicobacter pylori, associated with gastric MALT lymphoma. The presentation will focus on the latter three disorders, describing pathogenesis of disease, clinical manifestations and therapeutic options.
在全球范围内,约25%的人类恶性肿瘤由感染性生物体引起,其中包括在世界资源丰富地区发生的约10%的癌症。虽然其中一些疾病在潜在免疫缺陷患者中更易出现,但这并非恶性肿瘤发生的必要条件,事实上,大多数患者在诊断时并无免疫抑制。在考虑血液系统恶性肿瘤时,几种生物体与疾病病因有关。这些生物体包括人类疱疹病毒8型(HHV8/KSHV),它与原发性渗出性淋巴瘤、多中心Castleman病以及卡波西肉瘤的发生有关;爱泼斯坦-巴尔病毒(EBV),它与伯基特淋巴瘤和鼻T细胞淋巴瘤等有关;人类嗜T淋巴细胞病毒I型(HTLV-1),它与成人T细胞白血病/淋巴瘤(ATLL)有关;丙型肝炎病毒,与脾边缘区淋巴瘤及其他淋巴瘤有关;以及幽门螺杆菌,与胃黏膜相关淋巴组织淋巴瘤有关。本报告将重点关注后三种疾病,描述疾病的发病机制、临床表现和治疗选择。