Résumé
Background: Cancer is the third cause of death in patients infected with human immunodeficiency virus (HIV) and lymphoma is the most common type. Aim: To describe the clinical characteristics, histology, risk factors and prognosis of these patients, in a Chilean public hospital in Chile. Material and Methods: Records of 55 patients (45 males) aged between 23 and 67years with lymphoma and HIV positive serology, diagnosed between 1992-2008, were reviewed. Results: Six patients (11%) had Hodgkin lymphoma (HL) and the rest, non-Hodgkin lymphoma (NHL). B-cell phenotype constituted 83.7% of NHL cases. The most common subtypes of all the lymphoma were diffuse large B cell lymphoma in 24 cases (43.6%), Burkitt lym-phoma in 12 cases (21.8%), andplasmablastic lymphoma in 5 cases (9.1%). Thirty five patients (64%) underwent curative intended chemotherapy (CT) concomitantly with highly active antiretroviral therapy (HAART). Three year survival of the whole cohort was 27%. By multivariate analysis, the most important prognostic factors for long term survival, were complete responses to CT, (p < 0.01) and a low international prognostic index (IPI) score for NHL, (p = 0.01). HAART, histologic subtype and CD4 lymphocyte count at diagnosis, did not influence survival. Conclusions: The most important prognostic factors for HIV patients with lymphoma, were achieving CR with CT and low IPI score. Prognosis remains poor, even with HAART therapy.
Sujets)
Adulte , Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Jeune adulte , Séropositivité VIH/complications , Maladie de Hodgkin/anatomopathologie , Lymphome lié au SIDA , Thérapie antirétrovirale hautement active , Chili , Séronégativité VIH , Séropositivité VIH/traitement médicamenteux , Hôpitaux publics , Lymphome lié au SIDA/mortalité , Lymphome lié au SIDA/anatomopathologie , Pronostic , Taux de survieRésumé
Se analiza la evolución y resultado perinatal del total de gestaciones ocurridas en 19 años de experiencia en mujeres receptoras de un transplante renal, casuística que se inicia en 1982. El embarazo fue planeado en la mayoría de los casos, objetivado por cuanto la latencia entre transplante y gestación fue mayor a dos años en un 76 por ciento de los casos. Hubo un 53 por ciento de hipertensión, 58 por ciento de prematurez y 34 por ciento de RCIU. En nuestra serie no hubo malformados. No se pesquiso rechazo del riñon transplantado. Los abortos correspondieron a un 9 por ciento y excluyendo a éstos, el porcentaje de letalidad fue de 6,45 por ciento