10例艾滋病相关恶性淋巴瘤临床分析  

Clinical Analysis of 10 AIDS Patients with Malignant Lymphoma

作　　者：郜桂菊[1] 杨涤[1] 林可可[2] 肖江[1] 李鑫[1] 梁洪远[1] 刘龙[1] 韩宁[1] 赵红心[1] 

机构地区：[1]首都医科大学附属北京地坛医院,北京市100015 [2]北京大学护理学院

出　　处：《中国肿瘤临床》2011年第18期1114-1117,共4页Chinese Journal of Clinical Oncology

基　　金：国家十一五艾滋病和病毒性肝炎等重大传染病防治科技重大专项基金(编号:2008ZX10001-006)资助~~

摘　　要：目的:总结北京地坛医院收治的艾滋病合并恶性淋巴瘤患者的临床特点及诊治经过。方法:回顾性分析10例艾滋病合并恶性淋巴瘤患者的特点,从临床表现、病理检查及免疫水平、EBV抗体检查结果、并发症及治疗情况、转归等多角度进行分析。结果:10例患者主要临床表现有间断性发热2例,颈部肿物伴发热3例,腋窝淋巴结肿大2例,腹痛腹胀伴发热3例;病理诊断弥漫大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)7例,Burkitt淋巴瘤3例;CD4细胞计数<200/μL的8例,>200/μL者2例;EBV-IgM抗体阴性7例,未查3例;6例采取了不同方案和疗程的化疗,预后有差异,其中1例Burkitt淋巴瘤VP化疗后予以交替CODOXM与IVAV方案化疗3个周期,1例胃部伴肝转移DLBCL行R-CHOP化疗5次,后改为R-MINE、MINE化疗,1例肾上腺DLBCL患者CHOP化疗6个周期,3例DLBCL患者采取CHOP化疗I～2个周期,4例放弃治疗;化疗期间发生不同程度的感染、骨髓抑制、消化道出血、肾功能损害等不良反应。6例进行了高效抗逆转录病毒治疗(hignly active antiretroviral treatment,HAART),4例未行HAART;死亡6例,好转3例,1例自动出院。结论:艾滋病合并恶性淋巴瘤的患者临床表现多样,免疫力低下,多部位侵犯,就诊时已至淋巴瘤中晚期,化疗效果一般,并发症多,HAART不能明显改善患者预后,总体预后差。Objective： This work summarizes the clinical features and treatment of 10 AIDS patients with malignant lymphoma seen in the Beijing Ditan Hospital. Methods： A total of 10 AIDS in-patients with malignant lymphoma in Beijing Ditan Hospital since 2009 were enrolled. Clinical manifestations, pathologic examinations, immunity levels, Epstein-Barr virus antibody examinations, complications, treatments, and outcomes were retrospectively analyzed. Results： The main clinical manifestations of these patients included intermittent fever in 2 cases, neck masses and fever in 3cases, auxiliary lymph node enlargement in 2 cases, and abdominal pain and bloating with fever in 3 cases. Up to 7 patients were pathologically diagnosed with diffuse large B cell lymphoma （DLBCL）, and 3 patients were pathologically diagnosed with Burkitt＇s lymphoma. Up to 8 patients had CD4 cell counts below 200/μL, 2 patients had more than 200/μL. Up to 7 patients were negative for EBV-IgM antibodies and 3 patients were positive. Six patients underwent different chemotherapy treatments and their prognoses were different. One patient with Burkitt＇s lymphoma alternatively took CODOXM and IVAC for three turns after VP chemotherapy; ome patient with liver metastasis took R-CHOP five times, then changed therapy regimen to R-MINE, MINE. One patient with adrenal DLBCL took CHOP six times. Three patients with DLBCL took CHOP one or two times. Four patients gave up treatment. Various infections occurred, as well as side effects such as bone marrow suppression, gastrointestinal bleeding, and renal dysfunction during chemotherapy. Six patients took HAART, and four did not. Six patients died, whereas three pa- tients got improved; and 1 patient was automatically discharged. Conclusion： AIDS patients with malignant lymphoma had various clin- ical manifestations, were immunocompromised, and with multiple metastasis when they were admitted; they were already in the interim or late stage of lymphoma. Chemotherapy was not effective, and additional com

关 键 词：艾滋病 恶性淋巴瘤 化疗HAART预后 

分 类 号：R733.1[医药卫生—肿瘤] R512.91[医药卫生—临床医学]