Tirelli U, Errante D, Spina M, Vaccher E, Serraino D, Boiocchi M, Gloghini A, Carbone A
Division of Medical Oncology and AIDS, Centro di Riferimento Oncologico, Aviano, Italy.
Hematol Oncol. 1996 Mar;14(1):7-15. doi: 10.1002/(SICI)1099-1069(199603)14:1<7::AID-HON556>3.0.CO;2-D.
the overall outcome of patients with HIV-related non-Hodgkin's lymphomas (HIV-NHL) is poor because of the adverse clinico-pathological features of HIV-NHL and the underlying HIV infection. However, the experience of physicians in the management of HIV-NHL has increased, in particular in the use of intensive chemotherapy regimens, leading to an improvement in the prognosis of some of these neoplasms. Because some patients with AIDS may survive up to 5 years, it is possible to evaluate the long-term efficacy of the treatment of patients with HIV-NHL. In the general population, aggressive NHL, that are those occurring in HIV patients, may be considered cured after 2 years of lasting complete remission (CR) after chemotherapy.
we reviewed our monoinstitutional case-series of 73 HIV-infected patients with systemic NHL, observed between April 1985 and February 1993. Two groups of patients were arbitrarily identified, the first one (group A) including patients with a CR lasting for at least 2 years (N = 13) and the other including all remaining patients (group B) (N = 60).
the 13 patients of group A differed significantly from the other patients in terms of higher CD4+ cell count and performance status (PS) at the time of diagnosis of NHL. There was no significant difference in the histological subtypes of the HIV-NHLs. The overall survival of the 73 patients was 8 months. In a separate analysis on all patients, age less than 30 years, PS less or equal to 1, a CD4+ cell count equal to or higher than 100/mm3 and the absence of B symptoms were significantly associated with a longer survival. The median survival in patients of group A was 42 months, however none of these patients relapsed during a median observation time of 42 months (range, 24-90).
long-term survival and possibly cure can be obtained in some patients with HIV-NHL, in particular in those with a better PS and a less advanced immune dysfunction. In fact some of these patients are alive without evidence of disease 4 to 7 years after therapy, and others died of causes related to underlying HIV infection, in particular opportunistic infections, rather than relapse of NHL.
由于HIV相关非霍奇金淋巴瘤（HIV-NHL）不良的临床病理特征以及潜在的HIV感染，HIV-NHL患者的总体预后较差。然而，医生在HIV-NHL管理方面的经验有所增加，特别是在使用强化化疗方案方面，这使得其中一些肿瘤的预后得到改善。由于一些艾滋病患者可能存活长达5年，因此有可能评估HIV-NHL患者治疗的长期疗效。在一般人群中，侵袭性NHL（即发生在HIV患者中的那些）在化疗后持续完全缓解（CR）2年后可被视为治愈。
我们回顾了1985年4月至1993年2月间观察到的73例感染HIV且患有系统性NHL的单机构病例系列。任意确定两组患者，第一组（A组）包括CR持续至少2年的患者（N = 13），另一组包括所有其余患者（B组）（N = 60）。
A组的13例患者在NHL诊断时的CD4 +细胞计数和体能状态（PS）方面与其他患者有显著差异。HIV-NHL的组织学亚型没有显著差异。73例患者的总生存期为8个月。在对所有患者的单独分析中，年龄小于30岁、PS小于或等于1、CD4 +细胞计数等于或高于100/mm3以及无B症状与较长生存期显著相关。A组患者的中位生存期为42个月，然而在42个月（范围24 - 90个月）的中位观察期内，这些患者均未复发。
一些HIV-NHL患者可获得长期生存甚至可能治愈，特别是那些PS较好且免疫功能障碍不太严重的患者。事实上，其中一些患者在治疗后4至7年仍存活且无疾病证据，而其他患者死于与潜在HIV感染相关的原因，特别是机会性感染，而非NHL复发。
