在台湾，对一线治疗的完全缓解与 HIV 相关淋巴瘤的长期生存相关。
Complete response to front-line therapies is associated with long-term survival in HIV-related lymphomas in Taiwan.
机构信息
Department of Oncology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan.
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Department of Medicine, National Taiwan University Cancer Center, Taipei, Taiwan.
出版信息
J Microbiol Immunol Infect. 2024 Jun;57(3):426-436. doi: 10.1016/j.jmii.2024.04.001. Epub 2024 Apr 6.
BACKGROUND
The prognosis for people living with HIV (PLWH) who develop lymphomas has been greatly improved by combination antiretroviral therapy (cART) and anti-CD20 monoclonal antibodies. However, real-world clinical data on this patient group in Asia are limited.
METHODS
Treatment outcomes were retrospectively examined for 104 PLWH with lymphomas between 2000 and 2019. The cohort comprised five PLWH with Hodgkin lymphoma (HL) and 99 with non-Hodgkin lymphomas, including 61 with diffuse large B-cell lymphoma (DLBCL), 19 with Burkitt lymphoma (BL), nine with primary central nervous system lymphoma (PCNSL) and ten with other subtypes.
RESULTS
The 5-year overall survival (OS) rates were as follows: HL (100%), PCNSL (76.2%), other subtypes (60.0%), BL (57.4%), and DLBCL (55.6%). Individuals who achieved complete response (CR) to front-line therapies had a significantly better 5-year OS rate than those without (96.2% vs. 17.8%, p < 0.001). PLWH who received cART for ≤6 months had significantly lower CD4+ T-cell counts at lymphoma diagnosis than those who received cART for longer periods (p = 0.048). Additionally, the 5-year OS rate was better for PLWH who received cART for ≤6 months before lymphomas diagnosis than those who received cART for longer periods (64.5% vs. 51.9%, p = 0.114).
CONCLUSIONS
PLWH with DLBCL or BL had OS rates compatible to patients without HIV infection. Better outcomes for patients achieving CR to front-line therapy and those with shorter cART duration before lymphoma diagnosis suggest an underlying biological distinction in the lymphomas and the involvement of immunity, which warrants further studies.
背景
通过联合抗逆转录病毒疗法（cART）和抗 CD20 单克隆抗体，HIV 感染者（PLWH）发展为淋巴瘤的预后得到了极大改善。然而，亚洲该患者群体的实际临床数据有限。
方法
回顾性检查了 2000 年至 2019 年期间 104 例患有淋巴瘤的 PLWH 的治疗结果。该队列包括 5 例霍奇金淋巴瘤（HL）和 99 例非霍奇金淋巴瘤患者，其中 61 例为弥漫性大 B 细胞淋巴瘤（DLBCL），19 例为伯基特淋巴瘤（BL），9 例为原发性中枢神经系统淋巴瘤（PCNSL），10 例为其他亚型。
结果
5 年总生存率（OS）如下：HL（100%）、PCNSL（76.2%）、其他亚型（60.0%）、BL（57.4%）和 DLBCL（55.6%）。接受一线治疗达到完全缓解（CR）的个体 5 年 OS 率明显高于未达到 CR 的个体（96.2% vs. 17.8%，p<0.001）。接受 cART 治疗≤6 个月的 PLWH 在淋巴瘤诊断时的 CD4+T 细胞计数明显低于接受 cART 治疗时间更长的患者（p=0.048）。此外，在淋巴瘤诊断前接受 cART 治疗≤6 个月的 PLWH 的 5 年 OS 率优于接受 cART 治疗时间更长的患者（64.5% vs. 51.9%，p=0.114）。
结论
患有 DLBCL 或 BL 的 PLWH 的 OS 率与未感染 HIV 的患者相当。对一线治疗达到 CR 的患者和在淋巴瘤诊断前接受 cART 治疗时间较短的患者的结果更好，表明淋巴瘤存在潜在的生物学差异，涉及免疫，这需要进一步研究。
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