STUDY OF NON-HODGKIN'S LYMPHOMA IN THE SETTING OF SEVERE HIV INFECTION

严重 HIV 感染背景下的非霍奇金淋巴瘤研究

• 批准号: 3874492
• 负责人: R YARCHOAN
• 金额: --
• 依托单位: DIVISION OF CANCER TREATMENT
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/3874492
• 关键词: AIDS; AIDS therapy; B lymphocyte; Epstein Barr virus; HIV infections; antiAIDS agent; antiviral agents; cancer risk; colony stimulating factor; drug related neoplasm /cancer; human immunodeficiency virus; human subject; leukocyte activation /transformation; lymphoma; zidovudine

Lymphoma is a well known complication of HIV infection. Previous studies by this laboratory have identified several mechanisms of B cell activation in patients with HIV infection which may lead to lymphoma: 1) increased numbers of Epstein-Barr virus infected B cells; 2) T-cell dependent polyclonal B cell activation induced by HIV; and 3) antigen-specific B cell activation by HIV. We have recently observed that eight of 55 patients (14.5%) with AIDS or severe ARC entered onto three long-term phase I trials of azidothymidine (AZT) or AZT-containing regimens at the NCI between 1985 and 1987 developed a high-grade non-Hodgkin's lymphoma (NHL), B cell type after initiating antiretroviral treatment. The lymphomas developed a median of 23.8 months after the initiation of therapy. The estimated probability of developing lymphoma by 36 months was 46.4%. The patients who developed NHL had <100 T4 cells/mm(3) for a median of 17.8 months prior to that diagnosis. All patients presented with NHL in extranodal sites. Patients with symptomatic HIV infection who survive for up to three years on antiretroviral therapy may have a relatively high probability of developing lymphoma. As improved therapies for the treatment of HIV and its complications result in prolonged survival, NHL may become an increasingly significant problem. We are now exploring means of improving therapy in this disorder. In collaboration with Dwight Kaufman, M.D. in the Radiation Oncology Branch, we are conducting a trial of combination chemotherapy with AZT and GM-CSF. Preliminary results suggest that some patients may respond to this regimen but that toxicity can be a problem.

淋巴瘤是众所周知的HIV感染并发症。先前的研究 该实验室已经确定了B细胞激活的几种机制 HIV感染患者可能导致淋巴瘤：1）增加 爱泼斯坦 - 巴尔病毒感染B细胞的数量； 2）T细胞依赖性 HIV诱导的多克隆B细胞激活； 3）抗原特异性B细胞 艾滋病毒的激活。我们最近观察到55例患者中有8名 （14.5％）辅助或严重的弧线进入三个长期I期试验 1985年之间NCI的叠氮噻噻替胺（AZT）或含AZT的方案 1987年开发了高级非霍奇金淋巴瘤（NHL），B细胞类型 启动抗逆转录病毒治疗后。淋巴瘤发展了中位数 开始治疗后23.8个月。估计的概率 淋巴瘤的发展36个月为46.4％。发展的患者 NHL在此之前的中位数为17.8个月的中位数<100 T4细胞/mm（3） 诊断。所有患者在外道部位均出现了NHL。患者 有症状的艾滋病毒感染，最多生存了三年 抗逆转录病毒疗法的发展可能相对较高 淋巴瘤。作为治疗艾滋病毒及其治疗的改进疗法 并发症导致生存时间延长，NHL可能成为越来越多的 重大问题。我们现在正在探索改善治疗的方法 这个疾病。在辐射中与医学博士Dwight Kaufman合作 肿瘤学分支，我们正在进行一项与 AZT和GM-CSF。初步结果表明一些患者可能会做出反应 对于这种方案，但这种毒性可能是一个问题。