*Department of Hematology, National Hospital Organization Nagoya Medical Center, 4-1-1 Sannomaru, Naka-ku, Nagoya 460-0001, Japan.
Jpn J Clin Oncol. 2014 Apr;44(4):318-23. doi: 10.1093/jjco/hyu012. Epub 2014 Feb 20.
Acquired immunodeficiency syndrome-related non-Hodgkin lymphoma is treated similarly to non-acquired immunodeficiency syndrome lymphoma, but it is not clear whether highly intensive regimens are beneficial for acquired immunodeficiency syndrome-related Burkitt lymphoma. We conducted a multicenter retrospective survey to clarify the clinical outcomes of acquired immunodeficiency syndrome-related Burkitt lymphoma in the combined antiretroviral therapy era in Japan.
We retrospectively analyzed the outcome of 33 patients with acquired immunodeficiency syndrome-related Burkitt lymphoma, who were diagnosed at five regional hospitals for human immunodeficiency virus/acquired immunodeficiency syndrome in Japan between January 2002 and December 2010.
The median follow-up period was 20.0 months (range 0.5-92.7 months). Six (18.2%) patients were treated with cyclophosphamide, vincristine, doxorubicin, high-dose methotrexate, ifosphamide, etoposide and high-dose cytarabine, and 23 (69.7%) patients were treated with hyperfractionated cyclophosphamide, vincristine, doxorubicin, dexamethasone, high-dose methotrexate and high-dose cytarabine. The overall response rate for all patients was 78.8%, with a complete response rate of 72.7%. The two-year overall survival rate was 68.1%. There was no significant difference in overall survival between chemotherapeutic regimens with rituximab (n = 20) and without rituximab (n = 13) (P = 0.49). The two-year overall survival rate was 66.7% for patients receiving cyclophosphamide, vincristine, doxorubicin, dexamethasone, etoposide, ifosfamide and cytarabine, and was 72.6% for patients receiving cyclophosphamide, vincristine, doxorubicin, dexamethasone, methotrexate and cytarabine (P = 0.72). There was one treatment-related death.
Highly intensive chemotherapy would bring a high remission rate and prolonged overall survival for patients with acquired immunodeficiency syndrome-related Burkitt lymphoma.
艾滋病相关非霍奇金淋巴瘤的治疗与非艾滋病相关淋巴瘤相似,但高强度治疗方案是否对艾滋病相关伯基特淋巴瘤有益尚不清楚。我们进行了一项多中心回顾性研究,以阐明日本联合抗逆转录病毒治疗时代艾滋病相关伯基特淋巴瘤的临床结局。
我们回顾性分析了 2002 年 1 月至 2010 年 12 月期间在日本五家艾滋病病毒/艾滋病区域医院诊断的 33 例艾滋病相关伯基特淋巴瘤患者的结局。
中位随访时间为 20.0 个月(0.5-92.7 个月)。6 例(18.2%)患者接受环磷酰胺、长春新碱、多柔比星、大剂量甲氨蝶呤、异环磷酰胺、依托泊苷和大剂量阿糖胞苷治疗,23 例(69.7%)患者接受高剂量甲氨蝶呤和大剂量阿糖胞苷治疗。所有患者的总体缓解率为 78.8%,完全缓解率为 72.7%。两年总生存率为 68.1%。含利妥昔单抗(n=20)与不含利妥昔单抗(n=13)的化疗方案在总生存率方面无显著差异(P=0.49)。接受环磷酰胺、长春新碱、多柔比星、地塞米松、依托泊苷、异环磷酰胺和阿糖胞苷治疗的患者两年总生存率为 66.7%,接受环磷酰胺、长春新碱、多柔比星、地塞米松、甲氨蝶呤和阿糖胞苷治疗的患者两年总生存率为 72.6%(P=0.72)。有 1 例治疗相关死亡。
高强度化疗可为艾滋病相关伯基特淋巴瘤患者带来高缓解率和延长的总生存。