Jung C, Bogner J R, Goebel F
Medizinische Poliklinik des Klinikum Innenstadt, Infektionsambulanz, Pettenkoferstr. 8a, D-80336 Munich, Germany.
Eur J Med Res. 1998 Sep 17;3(9):439-42.
To study the relationship between effective antiretroviral therapy, monitored by CD4 counts, and it s influence on the clinical course of AIDS associated Kaposi's sarcoma.
Four representative cases with AIDS and advanced Kaposi's sarcoma (KS) showed improvement of histologically proven KS s in various sites, including pulmonary disease, treated with liposomal doxorubicin. CD4 counts increased significantly during administration of triple antiretroviral therapy. In three cases chemotherapy cycles were extended and subsequently discontinued for 4, 14 and 4 months, respectively, without any relapse. In one other case interferonalpha therapy has been started overlapping with doxorubicin prior to permanent discontinuation of doxorubicin.
Data of those patients suggest that in patients with increasing CD4 counts KS's chemotherapy intervals should be extended or even discontinued. In some patients change of therapy to interferon alpha can be considered. A potent combined antiretroviral therapy may enhance efficiency of KS treatment even in patients with high CD4 counts.
研究通过CD4细胞计数监测的高效抗逆转录病毒疗法及其对艾滋病相关卡波西肉瘤临床病程的影响。
4例患有艾滋病和晚期卡波西肉瘤(KS)的代表性病例,在接受脂质体阿霉素治疗后,包括肺部疾病在内的各个部位经组织学证实的KS均有改善。在三联抗逆转录病毒疗法给药期间,CD4细胞计数显著增加。3例患者化疗周期延长,随后分别停药4个月、14个月和4个月,均无复发。另一例患者在永久停用阿霉素之前,开始使用干扰素α与阿霉素联合治疗。
这些患者的数据表明,对于CD4细胞计数增加的患者,KS化疗间隔应延长甚至停药。对于一些患者,可以考虑改用干扰素α治疗。即使是CD4细胞计数较高的患者,强效联合抗逆转录病毒疗法也可能提高KS治疗的效果。