Sandler A S, Kaplan L D
Department of Oncology, University of Calfornia, San Francisco, USA.
Hematol Oncol Clin North Am. 1996 Oct;10(5):1111-24. doi: 10.1016/s0889-8588(05)70387-7.
Persons with HIV infection are at an increased risk of developing intermediate and high-grade non-Hodgkin's lymphomas. Patients present with wide-spread extranodal disease at the time of initial presentation, with unusual sites of disease common. Factors predictive of a poor prognosis are low performance status, history of AIDS prior to the diagnosis of lymphoma, bone marrow involvement, and low CD4 count. Experience suggests that in some patients, more aggressive chemotherapy may be associated with shortened survival time. Recent clinical trials have demonstrated that the use of either myeloid growth factors or reduced-dosage chemotherapeutic regimens can reduce the morbidity associated with chemotherapy. A number of new and exciting experimental treatments are now in clinical development. These include new chemotherapy-based regimens, immune modulators immunotoxin therapy, and cellular therapy. It is hoped that as we continue to learn more about the biology of the HIV-associated lymphomas, we can develop more rational and effective treatment modlities that take advantage of the unique molecular characteristics of these tumors.
感染艾滋病毒的人患中高级别非霍奇金淋巴瘤的风险增加。患者在初次就诊时即表现为广泛的结外疾病，常见疾病部位不寻常。预后不良的预测因素包括体能状态差、淋巴瘤诊断前有艾滋病病史、骨髓受累和CD4细胞计数低。经验表明，在一些患者中，更积极的化疗可能与生存时间缩短有关。最近的临床试验表明，使用髓系生长因子或降低剂量的化疗方案可以降低化疗相关的发病率。现在有许多新的、令人兴奋的实验性治疗方法正在临床开发中。这些包括基于化疗的新方案、免疫调节剂、免疫毒素疗法和细胞疗法。希望随着我们继续更多地了解与艾滋病毒相关淋巴瘤的生物学特性，我们能够开发出更合理、有效的治疗方式，利用这些肿瘤独特的分子特征。
