Wei-Li Ma , Wang-Da Liu , Hsin-Yun Sun , Wang-Huei Sheng , Szu-Min Hsieh , Shang-Ju Wu , Chien-Ching Hung
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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.</p></div><div><h3>Results</h3><p>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 (<em>p</em> = 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%, <em>p</em> = 0.114).</p></div><div><h3>Conclusions</h3><p>PLWH with DLBCL or BL had OS rates compatible to patients without HIV infection. 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引用次数: 0
摘要
抗逆转录病毒联合疗法（cART）和抗 CD20 单克隆抗体大大改善了罹患淋巴瘤的艾滋病病毒感染者（PLWH）的预后。然而，亚洲有关这一患者群体的实际临床数据却很有限。我们对2000年至2019年期间104名淋巴瘤患者的治疗结果进行了回顾性研究。其中包括5名霍奇金淋巴瘤（HL）患者和99名非霍奇金淋巴瘤患者，包括61名弥漫大B细胞淋巴瘤（DLBCL）患者、19名布基特淋巴瘤（BL）患者、9名原发性中枢神经系统淋巴瘤（PCNSL）患者和10名其他亚型淋巴瘤患者。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%）。对一线疗法获得完全应答（CR）的患者的5年OS率明显高于未获得完全应答的患者（96.2% vs. 17.8%，P < 0.001）。接受 cART 治疗时间≤6 个月的 PLWH 在淋巴瘤确诊时的 CD4+ T 细胞计数明显低于接受 cART 治疗时间更长的 PLWH（= 0.048）。此外，淋巴瘤确诊前接受cART治疗时间≤6个月的感染者的5年OS率（64.5% vs. 51.9%，= 0.114）优于接受cART治疗时间更长的感染者。患有DLBCL或BL的PLWH的OS率与未感染HIV的患者相当。一线治疗达到CR的患者和淋巴瘤确诊前接受cART治疗时间较短的患者的预后较好，这表明淋巴瘤存在潜在的生物学差异和免疫参与，值得进一步研究。
Complete response to front-line therapies is associated with long-term survival in HIV-related lymphomas in Taiwan
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.
期刊介绍：
Journal of Microbiology Immunology and Infection is an open access journal, committed to disseminating information on the latest trends and advances in microbiology, immunology, infectious diseases and parasitology. Article types considered include perspectives, review articles, original articles, brief reports and correspondence.
With the aim of promoting effective and accurate scientific information, an expert panel of referees constitutes the backbone of the peer-review process in evaluating the quality and content of manuscripts submitted for publication.
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