艾滋病合并非霍奇金淋巴瘤9例临床分析

发布时间：2018-04-14 14:19

本文选题：获得性免疫缺陷综合征 + 淋巴瘤　；参考：《吉林大学》2013年硕士论文

【摘要】：目的：艾滋病(AIDS)相关非霍奇金淋巴瘤(ARL)是艾滋病常见的相关恶性肿瘤之一。自广泛采用高效抗反转录病毒治疗(HAART)后，患者的免疫功能及其对化疗的耐受性明显提高,预后得到明显改善。通过分析9例艾滋病相关非霍奇金淋巴瘤(ARL)患者的临床资料，提高对ARL治疗的认识方法：分析吉林大学中日联谊医院和吉林省肿瘤医院2011年3月至2012年8月收治的9例ARL患者的临床资料。结果：9例ARL患者，均为男性，年龄28-65岁。6例患者在ARL诊治前1年内发现人类免疫缺陷病毒（HIV）感染，并在抗逆转录病毒治疗(HAART)中诊断NHL，1例患者在ARL诊治前2年内发现HIV感染，因副作用不能耐受并中断HAART治疗，并在诊断ARL后继续HAART治疗；2例患者在淋巴瘤诊治过程中发现HIV感染。发病时CD4+T细胞计数在(69～294)×106/L之间。2例患者以口腔内肿物起病，2例以咽痛、咽部溃疡起病，1例以牙龈肿物起病，，1例以上腭肿物起病，2例以发热、右侧腹股沟占位起病，1例以纵隔淋巴结占位起病，1例以颈部包块起病，1例以腹盆腔占位起病。3例为大B细胞性淋巴瘤浆母细胞型分化（或伴有），4例为弥漫大B细胞性淋巴瘤，1例为结外起病的T细胞淋巴瘤，1例为Burkitt淋巴瘤。8例患者给予全身化疗及靶向治疗、放疗为主的综合治疗，1例患者仅接受放疗。7例患者化疗同时联合HAART治疗，2例患者在HAART治疗开始后3个月开始化疗。3例完全缓解（其中1例随访半年后复发），2例部分缓解，1例病情无缓解，换用方案后病情稳定，1例患者死亡,另外1例，疗效达PR后病情进展死亡，1例病情进展。治疗的主要副作用为骨髓抑制。结论：ARL，积极的HAART联合利妥昔单抗及规范性化疗可能改善预后。
[Abstract]:Objective: AIDS- associated non-Hodgkin's lymphoma (ARL) is one of the most common malignant tumors associated with AIDS.Since HAART was widely used, the immune function and its tolerance to chemotherapy were improved, and the prognosis was improved significantly.The clinical data of 9 patients with AIDS-related non-Hodgkin 's lymphoma (ARL) were analyzed to improve the understanding of ARL treatment.Methods: the clinical data of 9 patients with ARL admitted from March 2011 to August 2012 in Jilin University Sino-Japanese Friendship Hospital and Jilin Provincial Cancer Hospital were analyzed.Results 9 cases of ARL patients, all male, aged 28-65 years, found HIV infection within 1 year before the diagnosis of ARL, and 1 case of HIV infection was found within 2 years before the diagnosis of ARL in one patient diagnosed with HAART in the course of antiretrovirals therapy.HAART was not tolerated and interrupted because of side effects, and HIV infection was found in 2 cases of lymphoma treated with HAART after the diagnosis of ARL.At the time of onset, the count of CD4 T cells was in the range of 69 ~ 294) 脳 10 ~ (-6) / L. 2 cases were caused by oral mass, 2 cases by pharynx pain, 1 case by gingival mass, 1 case by gingival mass, 2 cases by palatine disease, 2 cases by fever.1 case with mediastinal lymphadenopathy, 1 case with cervical mass, 1 case with abdominal and pelvic mass, 3 cases with large B cell lymphoma plasmoblastoid differentiation (or 4 cases with diffuse large B fine) with right inguinal locus lesion (1 case with mediastinal lymphadenopathy), 1 case with cervical mass disease, 1 case with abdominal and pelvic space occupying disease (3 cases) with large B cell lymphoma (or 4 cases with diffuse large B fine).One case of T cell lymphoma with extranodal disease and one case of Burkitt lymphoma were treated with systemic chemotherapy and targeted therapy.One patient received radiotherapy combined with chemotherapy combined with HAART only. 3 cases of complete remission began 3 months after HAART treatment (1 case was followed up for half a year) and 2 cases had relapsed.There was no remission in 1 patient with remission.One patient died of stable disease and the other one died after treatment, and one patient died after PR.The main side effect of the treatment was bone marrow suppression.Conclusion positive HAART combined with rituximab and normative chemotherapy may improve prognosis.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R733.1;R512.91

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