Hübel Kai, Re Alessandro, Boumendil Ariane, Finel Herve, Hentrich Marcus, Robinson Stephen, Wyen Christoph, Michieli Mariagrazia, Kanfer Edward, Diez-Martin Jose Luis, Balsalobre Pascual, Vincent Laure, Schroyens Wilfried, Santasusana Josep Maria Ribera, Kröger Nicolaus, Schiel Xaver, Cwynarski Kate, Esquirol Albert, Sousa Aida Botelho, Cattaneo Chiara, Montoto Silvia, Dreger Peter
University Hospital of Cologne, Cologne, Germany.
Hematology, Spedali Civili di Brescia, Brescia, Italy.
Bone Marrow Transplant. 2019 Oct;54(10):1625-1631. doi: 10.1038/s41409-019-0480-x. Epub 2019 Feb 25.
The present study aimed at describing the outcome of patients with HIV-associated lymphomas following autologous hematopoietic stem cell transplantation (autoHCT) in the rituximab and combined antiretroviral therapy (cART) era. Eligible for this retrospective study were HIV-positive patients with lymphoma who received autoHCT between 2007 and 2013. A total of 118 patients were included with a median age of 45 years (range 24-66). Underlying diagnoses were diffuse large B cell lymphoma in 47%, Hodgkin lymphoma in 24%, Burkitt lymphoma in 18%, and plasmablastic lymphoma in 7% of patients. Disease status at autoHCT was complete remission in 44%, partial remission (PR) in 38%, and less than PR in 18% of the patients. With a median follow-up of 4 years, 3-year non-relapse mortality, incidence of relapse, progression-free survival (PFS) and overall survival (OS) were 10%, 27%, 63% and 66%, respectively. By multivariate analysis, disease status less than PR but not CD4+ cell count at the time of autoHCT was a significant predictor of unfavorable PFS and OS. In conclusion, in the era of cART and chemoimmunotherapy, the outcome of autoHCT for HIV-related lymphoma is driven by lymphoma-dependent risk factors rather than by characteristics of the HIV infection.
本研究旨在描述在利妥昔单抗和联合抗逆转录病毒疗法（cART）时代，接受自体造血干细胞移植（autoHCT）的HIV相关淋巴瘤患者的治疗结果。本回顾性研究的纳入对象为2007年至2013年间接受autoHCT的HIV阳性淋巴瘤患者。共纳入118例患者，中位年龄为45岁（范围24 - 66岁）。基础诊断为弥漫性大B细胞淋巴瘤的患者占47%，霍奇金淋巴瘤占24%，伯基特淋巴瘤占18%，浆母细胞淋巴瘤占7%。autoHCT时的疾病状态为完全缓解的患者占44%，部分缓解（PR）的占38%，缓解程度低于PR的占18%。中位随访4年，3年无复发生存率、复发率、无进展生存期（PFS）和总生存期（OS）分别为10%、27%、63%和66%。多因素分析显示，autoHCT时疾病状态低于PR而非CD4 +细胞计数是PFS和OS不良的显著预测因素。总之，在cART和化疗免疫治疗时代，HIV相关淋巴瘤autoHCT的治疗结果取决于淋巴瘤相关的危险因素，而非HIV感染的特征。
