Liang Ying, Chang Jing, Gao Yuxue, Sun Lin, Yue Zhujun, Meng Lingjia, Guo Caiping, Zhang Yulin
Beijing Key Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China.
Department of Pathology, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China.
Ann Hematol. 2025 May 30. doi: 10.1007/s00277-025-06424-9.
AIDS-related lymphoma (ARL) is a leading cause of mortality among people living with HIV (PLWH), characterized by distinct clinicopathological features and a generally poor prognosis. However, comprehensive studies on ARL remain limited. This study aimed to evaluate the clinicopathological characteristics, immune status, and Epstein-Barr virus (EBV)/HIV viral loads in PLWH diagnosed with lymphoma, and to assess their prognostic significance. A retrospective analysis was conducted on 130 ARL cases diagnosed between 2017 and 2024. The cohort included 56 Burkitt lymphoma (BL), 51 diffuse large B-cell lymphoma (DLBCL), 9 Hodgkin lymphoma (HL), 8 plasmablastic lymphoma (PBL), and 6 T/NK cell lymphoma patients. The median age was 39 years, with 94.6% of patients being male. The 2-year overall survival (OS) rate was 50.6%, with HL showing the highest survival rate (85.7%) and BL the lowest (43.8%). Univariate analysis identified several factors significantly associated with poorer OS in non-Hodgkin lymphoma (NHL), including CD4 + T cell count < 200 cells/µL, presence of B symptoms, Eastern Cooperative Oncology Group (ECOG) performance status ≥ 2, elevated lactate dehydrogenase (LDH), Ann Arbor Stage III/IV disease, > 1 site with extranodal involvement, and bone marrow involvement (all P < 0.05). Multivariate analysis revealed that CD4 + T cell count < 200 cells/µL (HR: 2.085, P = 0.026) and elevated LDH (HR: 0.378, P = 0.005) were independent prognostic factors. In conclusion, NHL, particularly BL and DLBCL, is the predominant lymphoma subtype among PLWH. Severe immunodeficiency and elevated LDH may serve as effective prognostic factors for predicting OS in patients with AIDS-related NHL.
艾滋病相关淋巴瘤（ARL）是艾滋病毒感染者（PLWH）死亡的主要原因，其具有独特的临床病理特征且预后通常较差。然而，关于ARL的全面研究仍然有限。本研究旨在评估诊断为淋巴瘤的PLWH的临床病理特征、免疫状态以及爱泼斯坦-巴尔病毒（EBV）/艾滋病毒载量，并评估它们的预后意义。对2017年至2024年间诊断的130例ARL病例进行了回顾性分析。该队列包括56例伯基特淋巴瘤（BL）、51例弥漫性大B细胞淋巴瘤（DLBCL）、9例霍奇金淋巴瘤（HL）、8例浆母细胞淋巴瘤（PBL）和6例T/NK细胞淋巴瘤患者。中位年龄为39岁，94.6%的患者为男性。2年总生存率（OS）为50.6%，其中HL的生存率最高（85.7%），BL的生存率最低（43.8%）。单因素分析确定了非霍奇金淋巴瘤（NHL）中几个与较差OS显著相关的因素，包括CD4 + T细胞计数<200个细胞/微升、B症状的存在、东部肿瘤协作组（ECOG）体能状态≥2、乳酸脱氢酶（LDH）升高、Ann Arbor分期III/IV期疾病、>1个结外受累部位以及骨髓受累（所有P<0.05）。多因素分析显示，CD4 + T细胞计数<200个细胞/微升（HR：2.085，P = 0.026）和LDH升高（HR：0.378，P = 0.005）是独立的预后因素。总之，NHL，尤其是BL和DLBCL，是PLWH中主要的淋巴瘤亚型。严重免疫缺陷和LDH升高可能作为预测艾滋病相关NHL患者OS的有效预后因素。
