ABV方案化疗对艾滋病相关晚期卡波氏肉瘤外周血CD4淋巴细胞的影响  

The effect of ABV regimen chemotherapy on CD4 lymphocyte count in patients with advanced HIV related Kaposi sarcoma

作　　者：林琳[1] Datta Dharmadhikari 

机构地区：[1]福建省肿瘤医院内科,福州350014 [2]博茨瓦纳哈博罗内玛丽娜公主医院

出　　处：《临床肿瘤学杂志》2010年第7期628-630,共3页Chinese Clinical Oncology

摘　　要：目的探讨艾滋病相关晚期卡波氏肉瘤(KS)在高效抗逆转病毒治疗(HAART)耐药后联合应用ABV方案化疗的疗效及其对患者CD4的影响。方法收集经HAART无效且CD4降低,进展为晚期KS的176例患者,给予6个周期ABV方案化疗,观察化疗前、后CD4的变化及其与临床疗效之间的关系。结果 ABV方案化疗后的临床有效率(CR+PR)为93.7%,无效(PD+NC)为6.3%。CD4增加占89.8%,CD4降低占10.2%;化疗前CD4数值在有效组和无效组之间差异无统计学意义,化疗后CD4数值在两组之间有显著的统计学差异,有效组化疗后CD4升高(P<0.05),无效组化疗后CD4略降低(P>0.05)。结论 ABV方案化疗能有效治疗艾滋病相关晚期KS,并能有效提高患者CD4数值。Objective The combination of highly active anti retroviral therapy （HAART） and chemotherapy with ABV regimen （doxorubicin, bleomycin and vincristine ） is a promising approach for the treatment of advanced HIV-related Kaposi sarcoma （KS）. Here we analyze the relationship between the CD4 Lymphocyte cell count and the clinical response to chemotherapy. Methods One hundred and seventy-six HIV infected patients with advanced KS who failed to respond to prior HAART were selected. All these patients were then preceded to chemotherapy with ABV regimen which was administered at 3 weekly intervals for 6 cycles. For each patient CD4 cell counts were done before starting chemotherapy and after finishing 6 cycles of chemotherapy. The pre chemotherapy and post chemotherapy CD4 cell count difference was compared with the clinical progress of the patient after 6 cycles of chemotherapy. Results The overall clinical remission was seen in 93.7% patients. Progressive development （PD） and no change in clinical condition （NC） was seen in 6. 3% patients. The post chemotherapy increase in CD4 cell count was found in 89. 8% patients and the decrease in CD4 cell count was seen in 10. 2% patients. The difference of the mean CD4 cell counts for patients in the group CR ＋ PR before and after chemotherapy was highly significant. The difference of the mean CD4 cell count for patients in group NC ＋ PD before and after chemotherapy was slightly significant. The difference in CD4 cell counts in CR ＋ PR and NC ＋ PD group before chemotherapy was not significant. The difference in CIM cell counts in CR ＋ PR and NC ＋ PD before and after chemotherapy was highly significant. Conclusion The HIV related KS patients on HAART benefit from the chemotherapy as it increases the CD4 cell count and it has positive impact on clinical remission of KS.

关 键 词：CD4淋巴细胞 化学治疗 艾滋病 高效抗逆转病毒治疗 卡波氏肉瘤 

分 类 号：R730.263[医药卫生—肿瘤]