Treatment and Outcome of AIDS-related Lymphoma

随着高效抗逆转录病毒疗法(HAART)的使用，非霍奇金淋巴瘤(NHL)的机会性感染(OI)率下降，导致获得性免疫缺陷(AIDS)患者的死亡人数不断增加。虽然过去与艾滋病相关的非霍奇金淋巴瘤的预后很差，但HAART可能会改善预后。具体目标：1)我们将使用快速病例确定方法从基于人群的癌症登记中识别患有和不患有艾滋病的非霍奇金淋巴瘤患者。2)描述HIV特异性患者和AIDS-NHL患者的治疗特点，区分哪些因素影响预后。3)我们将描述伴有和不伴有艾滋病的非霍奇金淋巴瘤患者的肿瘤特征和癌症治疗，并区分哪些肿瘤特征影响预后。4)我们将确定HAART的使用如何影响国际预后指数(IPI)，并形成一个原始的预后模型。研究设计：利用快速病例确定，我们将联系在两年内向奥兰治、圣地亚哥和帝国郡癌症登记处报告的所有艾滋病-非霍奇金淋巴瘤病例，以及在同一两年期间报告的年龄、性别和种族/民族匹配的非艾滋病非霍奇金淋巴瘤病例样本。我们将对非霍奇金淋巴瘤患者进行访谈和图表审查，以收集影响预后的生物因素的信息，如非霍奇金淋巴瘤的部位、分期和病理分级，以及患者的具体特征，如种族/民族、表现状况和医疗保健途径。我们将收集有关HIV特有特征的数据，包括CD4细胞计数、HIV病毒载量、HIV风险因素以及对患有艾滋病的NHL患者使用HAART的情况。我们将在接受HAART和没有接受HAART的艾滋病患者之间进行为期三年的随访，比较患有和不患有艾滋病的NHL患者的存活率、合并症/OI的发展情况和生活质量(QOL)。最后，我们将确定HAART的使用如何影响IPI，并开发一个包含HIV相关因素、肿瘤特征、HAART和化疗的预后模型。

Non-Hodgkin's lymphoma (NHL) is an increasing cause of death among people with acquired immunodeficiency (AIDS) due to declining rates of opportunistic infection (OI) with the use of highly active antiretroviral therapy (HAART). While the prognosis of AIDS- related NHL has been poor in the past, HAART may improve outcomes. Specific Aims: 1) We will identify NHL patients with and without AIDS from the population-based cancer registry using a rapid case ascertainment method. 2) We will describe HIV-specific patient and treatment characteristics of AIDS-NHL patients and distinguish which factors influence prognosis. 3) We will describe tumor characteristics and cancer treatment in NHL patients with and without AIDS and distinguish which oncologic features influence prognosis. 4) We will determine how the use of HAART influences the International Prognostic Index (IPI) and form an original prognostic model. Research Design: Using rapid case ascertainment, we will contact all AIDS-NHL cases reported in a two-year period to the cancer registry for Orange, San Diego, and Imperial Counties and a sample of non- AIDS NHL cases matched on age, sex and race/ethnicity reported during the same two-year period. We will perform interviews and chart reviews on NHL patients to collect information on biologic factors that influence prognosis such as such as NHL site, stage, and pathologic grade as well as patient-specific features such as race/ethnicity, performance status, and health care access. We will gather data on HIV-specific features including CD4 cell count, HIV viral load, HIV risk factors, and use of HAART for NHL patients with AIDS. We will compare survival, development of co-morbidities/OI, and quality of life (QOL) between NHL patients with and without AIDS over a three-year follow-up period between AIDS patients who receive HAART and those who do not. Lastly, we will determine how the use of HAART influences the IPI and develop a prognostic model that incorporates HIV-related factors, tumor characteristics, HAART, and chemotherapy.