本文選題：獲得性免疫缺陷綜合征 + 淋巴瘤��； 參考：《吉林大學(xué)》2013年碩士論文

【摘要】：目的：艾滋病(AIDS)相關(guān)非霍奇金淋巴瘤(ARL)是艾滋病常見的相關(guān)惡性腫瘤之一。自廣泛采用高效抗反轉(zhuǎn)錄病毒治療(HAART)后，患者的免疫功能及其對化療的耐受性明顯提高,預(yù)后得到明顯改善。通過分析9例艾滋病相關(guān)非霍奇金淋巴瘤(ARL)患者的臨床資料，提高對ARL治療的認(rèn)識 方法：分析吉林大學(xué)中日聯(lián)誼醫(yī)院和吉林省腫瘤醫(yī)院2011年3月至2012年8月收治的9例ARL患者的臨床資料。 結(jié)果：9例ARL患者，均為男性，年齡28-65歲。6例患者在ARL診治前1年內(nèi)發(fā)現(xiàn)人類免疫缺陷病毒（HIV）感染，并在抗逆轉(zhuǎn)錄病毒治療(HAART)中診斷NHL，1例患者在ARL診治前2年內(nèi)發(fā)現(xiàn)HIV感染，因副作用不能耐受并中斷HAART治療，并在診斷ARL后繼續(xù)HAART治療；2例患者在淋巴瘤診治過程中發(fā)現(xiàn)HIV感染。發(fā)病時CD4+T細(xì)胞計數(shù)在(69～294)×106/L之間。2例患者以口腔內(nèi)腫物起病，2例以咽痛、咽部潰瘍起病，1例以牙齦腫物起病，，1例以上腭腫物起病，2例以發(fā)熱、右側(cè)腹股溝占位起病，1例以縱隔淋巴結(jié)占位起病，1例以頸部包塊起病，1例以腹盆腔占位起病。3例為大B細(xì)胞性淋巴瘤漿母細(xì)胞型分化（或伴有），4例為彌漫大B細(xì)胞性淋巴瘤，1例為結(jié)外起病的T細(xì)胞淋巴瘤，1例為Burkitt淋巴瘤。8例患者給予全身化療及靶向治療、放療為主的綜合治療，1例患者僅接受放療。7例患者化療同時聯(lián)合HAART治療，2例患者在HAART治療開始后3個月開始化療。3例完全緩解（其中1例隨訪半年后復(fù)發(fā)），2例部分緩解，1例病情無緩解，換用方案后病情穩(wěn)定，1例患者死亡,另外1例，療效達(dá)PR后病情進(jìn)展死亡，1例病情進(jìn)展。治療的主要副作用為骨髓抑制。 結(jié)論：ARL，積極的HAART聯(lián)合利妥昔單抗及規(guī)范性化療可能改善預(yù)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.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R733.1;R512.91

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 丁如鋼,趙松仁;HIV感染所致激發(fā)性惡性腫瘤12例分析[J];中國誤診學(xué)雜志;2005年15期

本文編號：1749690