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HIV status does not influence outcome in patients with classical Hodgkin lymphoma treated with chemotherapy using doxorubicin, bleomycin, vinblastine, and dacarbazine in the highly active antiretroviral therapy era.在高效抗逆转录病毒治疗时代，采用多柔比星、博来霉素、长春碱和达卡巴嗪化疗治疗经典霍奇金淋巴瘤的患者，其 HIV 状态并不影响预后。
J Clin Oncol. 2012 Nov 20;30(33):4111-6. doi: 10.1200/JCO.2011.41.4193. Epub 2012 Oct 8.
2
HIV-associated Hodgkin lymphoma during the first months on combination antiretroviral therapy.在开始联合抗逆转录病毒治疗的头几个月发生的 HIV 相关霍奇金淋巴瘤。
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Proportions of Kaposi sarcoma, selected non-Hodgkin lymphomas, and cervical cancer in the United States occurring in persons with AIDS, 1980-2007.1980-2007 年美国艾滋病患者中 Kaposi 肉瘤、某些非霍奇金淋巴瘤和宫颈癌的比例。
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HIV-1-related Hodgkin lymphoma in the era of combination antiretroviral therapy: incidence and evolution of CD4⁺ T-cell lymphocytes.在联合抗逆转录病毒治疗时代的 HIV-1 相关霍奇金淋巴瘤：CD4+T 淋巴细胞的发生率和演变。
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高效抗逆转录病毒疗法对人类免疫缺陷病毒感染者霍奇金淋巴瘤风险的影响。

Impact of highly effective antiretroviral therapy on the risk for Hodgkin lymphoma among people with human immunodeficiency virus infection.

机构信息

Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA.

出版信息

Curr Opin Oncol. 2012 Sep;24(5):531-6. doi: 10.1097/CCO.0b013e3283560697.

DOI:10.1097/CCO.0b013e3283560697
PMID:22729154
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3604881/
Abstract

PURPOSE OF REVIEW

To estimate the impact of highly effective antiretroviral therapy (ART) on the incidence and prognosis of Hodgkin lymphoma among people with human immunodeficiency virus infection or AIDS (PWHA).

RECENT FINDINGS

Age-adjusted incidence of Hodgkin lymphoma in PWHA is unchanged and is still five-fold to fifteen-fold higher than in the general population. Aging of the PWHA population with ART may account for increasing numbers of Hodgkin lymphoma cases. CD4 cell count has a complex relationship to Hodgkin lymphoma risk in PWHA. Depending on the time of measurement, Hodgkin lymphoma risk is highest with 50-249 CD4 cells/μl, and falling CD4 count on ART may be a harbinger of Hodgkin lymphoma onset. HIV load appears irrelevant to Hodgkin lymphoma. For obscure reasons, Hodgkin lymphoma risk may be elevated soon after starting ART, but the risk is probably modestly reduced with 6 or more months on ART. For PWHA who develop Hodgkin lymphoma, ART and ABVD chemotherapy can be administered safely, with one recent study demonstrating equivalent outcomes for HIV-positive and HIV-negative Hodgkin lymphoma patients.

SUMMARY

Vigilance for Hodgkin lymphoma is needed for immune-deficient PWHA, including those on ART. ART with opportunistic infection prophylaxis enables the delivery of effective chemotherapy for Hodgkin lymphoma, leading to a good prognosis.

摘要

目的综述

评估高效抗逆转录病毒疗法（ART）对人类免疫缺陷病毒（HIV）感染或艾滋病（AIDS）患者中霍奇金淋巴瘤（HL）的发病率和预后的影响。

最近发现

HIV 感染者或 AIDS 患者中霍奇金淋巴瘤的年龄校正发病率保持不变，仍比普通人群高五至十五倍。随着 ART 的应用，HIV 感染者或 AIDS 患者人群的老龄化可能导致霍奇金淋巴瘤病例的增加。CD4 细胞计数与 HIV 感染者或 AIDS 患者的霍奇金淋巴瘤风险之间存在复杂的关系。根据检测时间的不同，CD4 细胞计数在 50-249 个/μl 时，霍奇金淋巴瘤的风险最高，ART 时 CD4 计数下降可能预示着霍奇金淋巴瘤的发生。HIV 载量似乎与霍奇金淋巴瘤无关。由于某些原因，在开始 ART 后不久，霍奇金淋巴瘤的风险可能会升高，但随着 ART 治疗 6 个月或更长时间，风险可能会适度降低。对于发生霍奇金淋巴瘤的 HIV 感染者或 AIDS 患者，ART 和 ABVD 化疗可以安全地进行，最近的一项研究表明，HIV 阳性和 HIV 阴性霍奇金淋巴瘤患者的结局相当。

总结

接受 ART 治疗的免疫功能低下的 HIV 感染者或 AIDS 患者需要警惕霍奇金淋巴瘤。ART 联合机会性感染预防可使霍奇金淋巴瘤患者接受有效化疗，从而获得良好的预后。