Ragni M V, Belle S H, Jaffe R, Locker J, Duerstein S L, Bass D C, Addiego J E, Aledort L M, Barron L E, Brettler D B, Buchanan G R, Gill J C, Ewenstein B M, Green D, Hilgartner M W, Hoots W K, Kisker C T, Lovrien E W, Rutherford C J, Sanders N L, Smith K J, Stabler S P, Swindells S, White G C, Kingsley L A
University of Pittsburgh School of Medicine, Hemophilia Center of Western Pennsylvania 15213, USA.
J Acquir Immune Defic Syndr Hum Retrovirol. 1996 Sep;13(1):78-86. doi: 10.1097/00042560-199609000-00011.
We studied the characteristics and temporal trends of AIDS- associated non-Hodgkin's lymphoma (AIDS-NHL) in individuals with hemophilia. Prospective data were collected on 33 HIV-positive hemophiliacs with AIDS-NHL enrolled in the Hemophilia Malignancy Study (HMS), of whom 21 had primary and 12 had secondary or subsequent AIDS-defining illnesses, and analyzed for frequency and temporal trends. As compared with primary AIDS- NHL, secondary AIDS-NHL occurred at an older mean age, 37 versus 29 years (p = 0.12); at a lower mean CD4 count, 46 versus 154 (p = 0.07); after a longer period of immunosuppression (CD4 < 200/microl), 41 versus 16 months (p = 0.03); and with shorter median survival, 2 versus 7 months (p = 0.09). The presence of EBV in tumor tissue was associated with shorter survival, 1 versus 7 months (p = 0.17). Between 1981 and 1988 and 1989 and 1994, the proportion of primary AIDS diagnoses that were AIDS-NHL changed minimally, 4.6 versus 6.1%, whereas there were significant decreases in Pneumocystis carinii pneumonia (PCP, p = 0.02) and wasting (p = 0.07), and an increase in Candida (p = 0.004). These findings confirm that an increasing proportion of AIDS-NHL in hemophiliacs are occurring as secondary or later AIDS diagnoses, and they are associated with prolonged duration of immunosuppression.
我们研究了血友病患者中与艾滋病相关的非霍奇金淋巴瘤（AIDS-NHL）的特征和时间趋势。收集了参与血友病恶性肿瘤研究（HMS）的33例患有AIDS-NHL的HIV阳性血友病患者的前瞻性数据，其中21例患有原发性疾病，12例患有继发性或后续的艾滋病定义疾病，并对其频率和时间趋势进行了分析。与原发性AIDS-NHL相比，继发性AIDS-NHL的发病平均年龄较大，分别为37岁和29岁（p = 0.12）；平均CD4细胞计数较低，分别为46和154（p = 0.07）；在免疫抑制（CD4 < 200/μl）持续较长时间后发病，分别为41个月和16个月（p = 0.03）；中位生存期较短，分别为2个月和7个月（p = 0.09）。肿瘤组织中EBV的存在与生存期较短有关，分别为1个月和7个月（p = 0.17）。在1981年至1988年以及1989年至1994年期间，原发性艾滋病诊断中AIDS-NHL的比例变化极小，分别为4.6%和6.1%，而卡氏肺孢子虫肺炎（PCP，p = 0.02）和消瘦（p = 0.07）的比例显著下降，念珠菌感染比例上升（p = 0.004）。这些发现证实，血友病患者中越来越多的AIDS-NHL是作为继发性或更晚的艾滋病诊断出现的，并且它们与免疫抑制持续时间延长有关。
