Department of Medicine, University of Massachusetts Medical School-Baystate Medical Center, Springfield, Massachusetts.
Department of Pathology, University of Massachusetts Medical School-Baystate Medical Center, Springfield, Massachusetts.
Eur J Haematol. 2019 Dec;103(6):620-622. doi: 10.1111/ejh.13326. Epub 2019 Sep 30.
Despite advances in the treatment of most human immunodeficiency virus (HIV)-related lymphomas, the outcomes for patients with HIV-related plasmablastic lymphoma (PBL) remain poor. While studies have shown an increased survival for patients with most kinds of HIV-related lymphomas since the introduction of highly active antiretroviral therapy (HAART), the impact of HAART on survival in patients with HIV-related PBL is unclear, mainly because the condition is rare and the number of published studies is small. Few case reports have shown regression of PBL after initiation of HAART, however, usually followed by recurrence of PBL or achieved with a need for chemotherapy. We report the first case of PBL in a 38-year-old man with newly diagnosed HIV who achieved sustained remission after the initiation of HAART alone and who remains in remission seven years after diagnosis, without a need for chemotherapy or radiation. We illustrate the importance of initiating HAART therapy under the supervision of infectious disease specialists as soon as the PBL is diagnosed until future studies provide clear evidence in the management of HIV-related PBL.
尽管大多数人类免疫缺陷病毒 (HIV) 相关淋巴瘤的治疗已有进展,但 HIV 相关浆母细胞淋巴瘤 (PBL) 患者的预后仍然较差。虽然自高效抗逆转录病毒疗法 (HAART) 问世以来,大多数 HIV 相关淋巴瘤患者的生存率有所提高,但 HAART 对 HIV 相关 PBL 患者生存的影响尚不清楚,主要是因为这种疾病很少见,而且发表的研究数量较少。少数病例报告显示,HAART 开始后 PBL 会消退,但通常随后会复发 PBL 或需要化疗。我们报告了首例新诊断 HIV 患者的 PBL 病例,该患者单独接受 HAART 治疗后获得持续缓解,诊断后 7 年仍未缓解,无需化疗或放疗。我们说明了在传染病专家的监督下尽快开始 HAART 治疗的重要性,直到未来的研究为 HIV 相关 PBL 的管理提供明确的证据。