Liu Y, Wang C Y
Hematology-Oncology Center, Chongqing University Cancer Hospital, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing 400030, China.
Zhonghua Xue Ye Xue Za Zhi. 2025 Feb 14;46(2):120-125. doi: 10.3760/cma.j.cn121090-20241108-00441.
The overall incidence of lymphomas associated with HIV infection is low, and only few hematological oncology specialties provide standardized treatment. Newly diagnosed patients with impaired immune function have a high incidence of complications, such as infections during induction chemotherapy, which increases treatment difficulties. For patients with relapse/refractory status, salvage treatment options are extremely limited, because new drug clinical trials are lacking. At present, both domestic and international clinical practices have shown that patients with lymphomas associated with HIV infection can achieve long-term survival after standardized combination antiretroviral therapy (cART) with targeted immunochemotherapy, followed by autologous hematopoietic stem cell transplantation (auto-HSCT) immediately after achieving complete remission. In recent years, some new drugs, such as XPO1 inhibitors, immune checkpoint inhibitors, antibody-drug conjugates (ADC drugs), bispecific antibodies, and small-molecule drugs, have been tentatively incorporated into treatment regimens for patients with lymphomas associated with HIV infection, and preliminary clinical data have been obtained. Based on two patients with lymphomas associated with HIV infection who were admitted to our center, this study proposed a standardized diagnostic and treatment pathway and provided corresponding references for clinicians to apply new drugs. The aim of this study was to promote diagnostic and treatment capabilities and improve the survival and quality of life of patients of lymphomas associated with HIV infection in China.
与HIV感染相关的淋巴瘤总体发病率较低，只有少数血液肿瘤专科提供标准化治疗。新诊断的免疫功能受损患者并发症发生率高，如诱导化疗期间的感染，这增加了治疗难度。对于复发/难治性患者，挽救治疗选择极其有限，因为缺乏新药临床试验。目前，国内外临床实践均表明，与HIV感染相关的淋巴瘤患者在接受标准化联合抗逆转录病毒治疗（cART）并联合靶向免疫化疗后，在完全缓解后立即进行自体造血干细胞移植（auto-HSCT），可实现长期生存。近年来，一些新药，如XPO1抑制剂、免疫检查点抑制剂、抗体药物偶联物（ADC药物）、双特异性抗体和小分子药物，已被尝试纳入与HIV感染相关的淋巴瘤患者的治疗方案，并获得了初步临床数据。基于我院收治的2例与HIV感染相关的淋巴瘤患者，本研究提出了标准化的诊疗路径，为临床医生应用新药提供了相应参考。本研究旨在提高我国与HIV感染相关的淋巴瘤患者的诊疗能力，提高患者生存率和生活质量。
