Pathology, Centro di Riferimento Oncologico (CRO), IRCCS, National Cancer Institute, Aviano, Italy.
Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
Expert Rev Hematol. 2021 Jun;14(6):547-559. doi: 10.1080/17474086.2021.1935851. Epub 2021 Jul 8.
: Hodgkin lymphoma (HL) can occur in different host conditions, i.e. in the general population and immunocompromised individuals, either during HIV infection or solid organ/hematopoietic transplantation and immunosuppressive drug treatment.: Areas covered include multidimensional characteristics of tumor cells and cellular composition of tumor microenvironment of HL. Current conventional treatments and new treatment strategies for HL in immunosuppressed patients, especially in persons living with HIV (PLWH), are also discussed.PubMed and MEDLINE were used for database searches to identify articles in English published from 1989 to 2020.: For people with post-transplant HL or for those with HIV/AIDS-associated HL, standard treatments mirror those in the general population. In the last decade, the combination of cART with anti-neoplastic treatments, alongside with current anti-rejection therapies, has increased long-term survival of people with HL and acquired immune deficiencies. High-dose chemotherapy and autologous stem cell transplantation have been favorably proven as salvage therapy in PLWH with relapsed and refractory HL. Immune checkpoint inhibitors emerged as an area of clinical investigation for relapsed and refractory HL in the general population. Pembrolizumab, an anti-programmed cell death protein 1 (PD-1) drug, resulted safe in PLWH indicating that PD-1 ligand assessment should be advisable in HIV-associated HL.
霍奇金淋巴瘤(HL)可在不同的宿主条件下发生,即在一般人群和免疫功能低下的个体中,无论是在 HIV 感染期间还是在实体器官/造血干细胞移植和免疫抑制药物治疗期间。涵盖的领域包括 HL 肿瘤细胞的多维特征和肿瘤微环境的细胞组成。目前针对免疫抑制患者(尤其是 HIV 感染者(PLWH))的 HL 的常规治疗和新的治疗策略也进行了讨论。使用 PubMed 和 MEDLINE 数据库搜索来确定 1989 年至 2020 年期间以英文发表的文章。对于移植后 HL 患者或与 HIV/AIDS 相关的 HL 患者,标准治疗与一般人群相同。在过去十年中,cART 联合抗肿瘤治疗以及当前的抗排斥治疗,提高了 HL 和获得性免疫缺陷患者的长期生存率。大剂量化疗和自体造血干细胞移植已被证明是 PLWH 复发和难治性 HL 的挽救性治疗方法。免疫检查点抑制剂已成为一般人群中复发和难治性 HL 的临床研究领域。抗程序性细胞死亡蛋白 1(PD-1)药物 pembrolizumab 在 PLWH 中是安全的,这表明在 HIV 相关 HL 中应评估 PD-1 配体。