Prognostic factors and outcome of human herpesvirus 8-associated primary effusion lymphoma in patients with AIDS
Prognostic factors and outcome of human herpesvirus 8-associated primary effusion lymphoma in patients with AIDS
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DOI：
10.1200/jco.2005.07.084
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发表时间：
2005-07-01
影响因子：
45.3
通讯作者：
Oksenhendler, E
中科院分区：
文献类型：
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作者：
Boulanger, E;Gérard, L;Oksenhendler, E
目的原发性渗出性淋巴瘤（Primary effusion lymphoma，PEL）是一种罕见的高级别B细胞非霍奇金淋巴瘤，与Kaposi肉瘤相关疱疹病毒/人类疱疹病毒8型（Kaposi sarcoma-associated herpesvirus/human herpesvirus 8，KSHV/HHV-8）感染有关，多见于HIV感染过程中，预后差，据报道中位生存期短于6个月。到目前为止，没有预后因素已确定在这个子集的lymphocyte.Patients和方法，我们在这里描述了一个大系列的HIV感染的患者与PEL，包括28例诊断在6个中心在11年的时间内，预后分析进行了使用考克斯比例风险回归模型。统计学显着的协变量进行了进一步分析，在一个向前的，逐步的多变量model.Results后，中位数随访3.8年（范围，10个月至10，8年），9例（32%）仍然活着，其中8人保持无进展。中位生存期为6.2个月，1年总生存率为39.3%。完全缓解14例（50%），1年无病生存率为78.6%。多因素分析中，体力状态> 2（风险比，5.84; 95% CI，1.76至19.33）和在确诊PEL前缺乏高效抗逆转录病毒治疗（HAART）（风险比，3.26; 95%CI为1.14 ~ 9.34）是生存期缩短的独立预测因子。两个预后因素被确定为与HIV相关的PEL的临床结局受损独立相关-（1）较差的体能状态和（2）在PEL诊断之前没有HAART。(c)2005年，美国临床肿瘤学会。
Purpose Primary effusion lymphoma (PEL) is a rare high-grade B-cell non-Hodgkin's lymphoma associated with Kaposi sarcoma-associated herpesvirus/human herpesvirus 8 (KSHV/HHV-8) infection, and is mostly observed in the course of HIV infection, The prognosis is poor, with reported median survival time shorter than 6 months. To date, no prognostic factor has been identified in this subset of lymphoma.Patients and Methods We describe here a large series of HIV-infected patients with PEL, including 28 cases diagnosed in six centers during an 11-year time period, Prognosis analysis was performed using a Cox proportional hazard regression model. Statistically significant covariates were further analyzed in a forward, stepwise multivariate model.Results After a median follow-up of 3.8 years (range, 10 months to 10,8 years), nine patients (32%) were still alive, and eight of them remained progression free. The median survival was 6,2 months, and the 1-year overall survival rate was 39.3%. Fourteen patients (50%) achieved complete remission, with a 1-year disease-free survival rate at 78.6%, In a multivariate analysis, only a performance status more than 2 (hazard ratio, 5,84; 95% CI, 1.76 to 19,33) and the absence of highly active antiretroviral therapy (HAART) before PEL diagnosis (hazard ratio, 3.26; 95% CI, 1.14 to 9.34) were found to be independent predictors for shorter survival.Conclusion Based on a retrospective series of 28 patients, two prognostic factors were identified as being independently associated with impaired clinical outcome in HIV-related PEL-(1) a poor performance status and (2) the absence of HAART before PEL diagnosis. (c) 2005 by American Society of Clinical Oncology.