Xiong Yu, Liu Weicheng, Chen Xiaoping, Mo Pingzheng, Xiong Yong, Deng Liping, Zhang Yongxi
Department of Radiation and Medical Oncology for Esophageal Mediastinal and Lymphatic Tumors, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.
Hubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.
Sci Rep. 2024 Dec 5;14(1):30397. doi: 10.1038/s41598-024-80749-9.
Combination antiretroviral therapy (ART) has improved outcomes for human immunodeficiency virus (HIV) associated non-Hodgkin lymphoma. This is an analysis of 127 patients with HIV with Burkitt lymphoma (HIV-BL) and diffuse large B-cell lymphoma (HIV-DLBCL) treated at the Zhongnan Hospital of Wuhan University over a 17-year period during the ART and rituximab era. The median CD4 count for the cohorts was 0.141 × 109/L (range, 0.001-0.861 × 109/L). DA-EPOCH ± R (54%) were most commonly used in HIV-BL. CHOP± R (42%) was most commonly used to treat HIV-DLBCL. The complete response rate after first-line curative therapy was 10/28 (36%) in HIV-BL and 25/57 (44%) in HIV-DLBCL. The 2-year progression-free survival (PFS) and overall survival (OS) for the HIV-BL cohort was 50% and 41% respectively. The 2-year PFS and OS for the HIV-DLBCL cohort was 55% and 47% respectively. Current China practice favours the treatment of HIV-BL and HIV-DLBCL similarly to the HIV-negative population with the use of concurrent ART. However, due to the extremely low percentage of patients receiving ART prior to the lymphoma diagnosis, the high percentage of patients with poor performance status, and the advanced stage at diagnosis, the treatment of HIV-related lymphoma remains the major challenge in China.
联合抗逆转录病毒疗法（ART）改善了人类免疫缺陷病毒（HIV）相关非霍奇金淋巴瘤的治疗效果。本文分析了武汉大学中南医院在ART和利妥昔单抗时代17年间收治的127例患有伯基特淋巴瘤（HIV-BL）和弥漫性大B细胞淋巴瘤（HIV-DLBCL）的HIV患者。这些队列患者的CD4计数中位数为0.141×10⁹/L（范围为0.001 - 0.861×10⁹/L）。DA-EPOCH ± R方案（54%）最常用于HIV-BL的治疗。CHOP± R方案（42%）最常用于治疗HIV-DLBCL。一线根治性治疗后的完全缓解率在HIV-BL中为10/28（36%），在HIV-DLBCL中为25/57（44%）。HIV-BL队列的2年无进展生存期（PFS）和总生存期（OS）分别为50%和41%。HIV-DLBCL队列的2年PFS和OS分别为55%和47%。目前中国的治疗实践倾向于像治疗HIV阴性人群一样，使用ART同时治疗HIV-BL和HIV-DLBCL。然而，由于淋巴瘤诊断前接受ART治疗的患者比例极低、体能状态差的患者比例高以及诊断时处于晚期，HIV相关淋巴瘤的治疗在中国仍然是一项重大挑战。
