Viera Plasencia Alejandra, I Purow Jeremy, Steger Julia, Brown-Whalen Alexander, Qadri Henna, Duque Clavijo Nicolas, Ruiz-Andia Marco
Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA.
Memorial Healthcare System, Hollywood, FL, USA.
SAGE Open Med. 2025 Sep 13;13:20503121251374954. doi: 10.1177/20503121251374954. eCollection 2025.
Chimeric antigen receptor T-cell therapy has emerged as a highly effective treatment for relapsed and refractory lymphomas; however, its application in individuals with human immunodeficiency virus remains underexplored. People with human immunodeficiency virus face an increased risk of developing malignancies such as lymphoma, where standard chemotherapy often results in suboptimal responses and heightened toxicity.
To review and synthesize current literature on the use of chimeric antigen receptor T-cell therapy and bispecific antibodies in human immunodeficiency virus-associated lymphoma, examining efficacy, safety, and potential barriers to implementation.
A systematic review of the literature was conducted using PubMed. Included studies comprised clinical trials, cohort studies, case reports, and preclinical research published between January 2000 and September 2024. Search terms included "HIV," "lymphoma," "CAR T cell therapy," "bispecific antibodies," "immunotherapy," and "HIV-associated lymphoma."
Preliminary data suggest chimeric antigen receptor T-cell therapy is feasible in human immunodeficiency virus-positive patients, with response rates comparable to human immunodeficiency virus-negative populations and manageable adverse events, including cytokine release syndrome and neurotoxicity. Engineering chimeric antigen receptor T cells to target human immunodeficiency virus-infected cells is under investigation as a potential curative strategy. However, challenges such as immunosuppression, low antigen expression, and interactions with antiretroviral therapy complicate treatment. Bispecific antibodies have shown promise in hematologic malignancies, but data in people with human immunodeficiency virus remain limited due to trial exclusions.
Early findings support the feasibility and potential efficacy of chimeric antigen receptor T-cell therapy in human immunodeficiency virus-associated lymphoma. Larger, controlled trials are needed to establish safety, optimize treatment strategies, and expand therapeutic options for people with human immunodeficiency virus.
嵌合抗原受体T细胞疗法已成为复发性和难治性淋巴瘤的一种高效治疗方法；然而，其在人类免疫缺陷病毒感染者中的应用仍未得到充分探索。人类免疫缺陷病毒感染者患淋巴瘤等恶性肿瘤的风险增加，而标准化疗往往导致疗效欠佳且毒性增强。
回顾和综合当前关于嵌合抗原受体T细胞疗法和双特异性抗体在人类免疫缺陷病毒相关淋巴瘤中的应用的文献，研究疗效、安全性及实施的潜在障碍。
使用PubMed对文献进行系统回顾。纳入的研究包括2000年1月至2024年9月发表的临床试验、队列研究、病例报告和临床前研究。检索词包括“HIV”“淋巴瘤”“CAR T细胞疗法”“双特异性抗体”“免疫疗法”及“HIV相关淋巴瘤”。
初步数据表明，嵌合抗原受体T细胞疗法在人类免疫缺陷病毒阳性患者中可行，缓解率与人类免疫缺陷病毒阴性人群相当，不良事件可控，包括细胞因子释放综合征和神经毒性。将嵌合抗原受体T细胞设计成靶向人类免疫缺陷病毒感染细胞作为一种潜在的治愈策略正在研究中。然而，免疫抑制、低抗原表达以及与抗逆转录病毒疗法的相互作用等挑战使治疗变得复杂。双特异性抗体在血液系统恶性肿瘤中已显示出前景，但由于试验排除标准，人类免疫缺陷病毒感染者的数据仍然有限。
早期研究结果支持嵌合抗原受体T细胞疗法在人类免疫缺陷病毒相关淋巴瘤中的可行性和潜在疗效。需要开展更大规模的对照试验，以确定安全性、优化治疗策略并为人类免疫缺陷病毒感染者拓展治疗选择。
