%0 Journal Article
%T 人类免疫缺陷病毒阳性和阴性弥漫大Ｂ细胞淋巴瘤的临床特点及近期疗效分析
%A Kumar Saurabha
%A Nancy Kablay
%A 庞红霞
%A 朱晋峰
%J 肿瘤防治研究
%D 2016
%R 10.3971/j.issn.1000-8578.2016.05.014
%X 摘要 目的 分析比较人类免疫缺陷病毒（HIV）阳性与阴性弥漫大B细胞淋巴瘤患者的临床特点及疗效。方法 收集博茨瓦纳弗朗西斯敦市仰加奎医院肿瘤内科2012年3月至2015年3月诊治的弥漫大Ｂ细胞淋巴瘤患者共71例，其中HIV阳性37例，HIV阴性34例，给予CHOP方案一线化疗，对两组的临床特点及疗效进行分析。结果 与HIV阴性组相比，HIV阳性组B症状发生率高（56.8% vs. 29.4%; P=0.020），更容易出现胃肠道（37.8% vs. 14.7%; P=0.028）、肝（29.7% vs. 9.7%; P=0.027）、肺（27.0% vs. 9.7%; P=0.048）浸润。HIV阳性组与HIV阴性组治疗完全缓解率分别为18.9%（7/37）与41.2%（14/34）（P=0.040）；客观有效率分别为48.6%（18/37）与70.6%（24/34）（P=0.060）。HIV阳性组化疗后出现贫血、白细胞下降及继发感染比例高于HIV阴性组（均P<0.05）。HIV阳性组中有24例在确诊淋巴瘤前已给予高效价抗逆转录病毒治疗（highly active antiretroviral therapy,HAART）治疗，13例确诊后给予HARRT治疗，其客观有效率分别为41.7%和61.5%（P=0.248）。CD4+细胞数>200/mm3和≤200/mm3患者，其客观有效率分别为71.4%和34.8%（P=0.031）。结论 HIV阳性患者就诊时表现出更强的侵袭性。结合HARRT治疗，CHOP方案可使HIV阳性患者达到类似于HIV阴性患者的客观有效率，但完全缓解率低。HIV阳性组患者HARRT起始治疗时间不影响近期疗效。CD4+细胞数低是近期疗效不良的预测因素
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%U http://www.zlfzyj.com/CN/abstract/abstract8752.shtml