Penkowa M, Hansen P B
H:S Rigshospitalet, epidemiafdeling M.
Ugeskr Laeger. 1998 Apr 27;160(18):2685-8.
Patients infected with HIV are at high risk for developing non-Hodgkin's lymphomas (NHL). HIV-associated NHLs seem to be increasing in number. They consist of two major histopathological subtypes originating from B-lymphocytes: Burkitt-like lymphomas and diffuse large cell lymphomas. There seems to be a clear association between Epstein-Barr virus (EBV) and immunoblastic lymphomas (a subtype of large cell lymphomas) in AIDS patients. Patients with AIDS often have widespread disease at presentation and frequent involvement of extranodal sites (CNS, liver, bone marrow, the digestive tract and skin). The treatment of NHL in AIDS patients is controversial due to their poor response to chemotherapy as well as a tendency to develop severe hematological toxicity. Factors with a negative influence on the prognosis are: Extranodal localisation of NHL including CNS, CD4 count below 200 x 10(6)/l, platelet count below 130 x 10(9)/l, widespread symptoms of disease, presence of EBV in the lymphoma and immunoblastic histology.
感染艾滋病毒的患者患非霍奇金淋巴瘤(NHL)的风险很高。与艾滋病毒相关的非霍奇金淋巴瘤数量似乎在增加。它们由源自B淋巴细胞的两种主要组织病理学亚型组成:伯基特样淋巴瘤和弥漫性大细胞淋巴瘤。在艾滋病患者中,爱泼斯坦-巴尔病毒(EBV)与免疫母细胞淋巴瘤(大细胞淋巴瘤的一种亚型)之间似乎存在明显关联。艾滋病患者在就诊时通常病情广泛,结外部位(中枢神经系统、肝脏、骨髓、消化道和皮肤)常受累。由于艾滋病患者对化疗反应不佳以及有发生严重血液学毒性的倾向,其非霍奇金淋巴瘤的治疗存在争议。对预后有负面影响的因素包括:非霍奇金淋巴瘤的结外定位,包括中枢神经系统、CD4计数低于200×10⁶/l、血小板计数低于130×10⁹/l、广泛的疾病症状、淋巴瘤中存在EBV以及免疫母细胞组织学。