Mwanda O W
Department of Haematology and Blood Transfusion, College of Health Sciences, University of Nairobi.
East Afr Med J. 1997 Nov;74(11):737-9.
This second part of the review looks at change seen in the bone marrow haemostasis and malignancies found in HIV infection. Examination of bone marrow is requested in the presence of cytopaenias, splenomegaly, lymphomas and myelodysplasia. The findings include marrow hypocellularity, myelodysplasia and poor marrow recovery. Dysmegakaryocytpoiesis is found in 88% while dyserythropoeisis in 83% of cases. Mechanisms leading to these pertubations include direct HIV effect on marrow progenitor cells, effect of drugs and other infective diseases. Altered levels and functions of growth modifies IL6 and G-CSF are also to contribute. Haemostatic disorder frequently noted is bleeding due to thrombocytopaenia. Non-Hodgkin's lymphomas with aggressive characteristics and Kaposi's sarcoma are the commonly associated malignancies. Currently IL6 is being linked with the causation of KS and NHL. While standard approaches to the management of these malignancies tend to be the practices, adjustments are usually necessary in most patients.
本综述的第二部分探讨了HIV感染中骨髓止血和恶性肿瘤方面的变化。出现血细胞减少、脾肿大、淋巴瘤和骨髓发育异常时需进行骨髓检查。检查结果包括骨髓细胞减少、骨髓发育异常和骨髓恢复不良。88%的病例存在巨核细胞生成异常，83%的病例存在红细胞生成异常。导致这些紊乱的机制包括HIV对骨髓祖细胞的直接作用、药物作用和其他感染性疾病。生长调节因子IL6和G-CSF水平及功能的改变也有影响。常见的止血障碍是血小板减少导致的出血。具有侵袭性特征的非霍奇金淋巴瘤和卡波西肉瘤是常见的相关恶性肿瘤。目前IL6与KS和NHL的病因有关。虽然这些恶性肿瘤的标准治疗方法通常是常用的，但大多数患者通常需要进行调整。
