W Luo, Q H Ma, L Y He, H C Wang, F L Wu, J W Hu, Y Wu, T Tao
{"title":"[艾滋病相关弥漫大 B 细胞淋巴瘤的临床特征和预后因素]。","authors":"W Luo, Q H Ma, L Y He, H C Wang, F L Wu, J W Hu, Y Wu, T Tao","doi":"10.3760/cma.j.cn112150-20240422-00332","DOIUrl":null,"url":null,"abstract":"<p><p>To explore the general clinical features and treatment outcomes of patients with AIDS-related diffuse large B-cell lymphoma (AIDS-DLBCL) and provide a theoretical basis for diagnosis and treatment, survival prognosis, prevention and management of AIDS-DLBCL patients. AIDS-DLBCL patients who received combined antiretroviral therapy (cART) at Changsha First Hospital from January 2017 to January 2020 were selected in this study. The survival curves were plotted using the Kaplan-Meier method, and the Cox proportional hazards regression model was used to analyze the association between AIDS-DLBCL specific variables and progression-free survival and overall survival. Correlation analysis was conducted based on the clinical features of the patients. A total of 50 AIDS-DLBCL patients were included. Their median age (<i>Q<sub>1</sub>, Q<sub>3</sub></i>) was 52 (44, 59) years, of whom 46 (92%) were male. About 20 (40%) patients received treatment with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), while 23 patients (46%) received treatment with rituximab combined with cyclophosphamide, doxorubicin, vincristine, and prednisone (RCHOP). Survival curve analysis showed that the 2-year progression-free survival rate and overall survival rate of AIDS-DLBCL patients were 56.9% and 61.6%, respectively. Patients with RCHOP protocol combined with EBV-DNA≥1 000 copies/ml had higher progression-free survival rate (χ<sup>2</sup>=3.844, <i>P</i>=0.043) and overall survival rate (χ<sup>2</sup>=4.662, <i>P</i>=0.031) than those with CHOP protocol combined with EBV-DNA≥1 000 copies/ml. A multivariate analysis showed that male (<i>HR</i>=2.70, 95%<i>CI</i>:1.10-6.80), EB viral load≥1 000 copies/ml (<i>HR</i>=1.75, 95%<i>CI</i>:1.12-2.84), HIV-RNA≥200 copies/ml (<i>HR</i>=4.64, 95%<i>CI</i>: 1.73-12.15), ECOG PS score of 2 to 4 points (<i>HR</i>=3.54, 95%<i>CI</i>:1.62-7.33), and international prognostic index (IPI) score of 3 to 5 points (<i>HR</i>=5.21, 95%<i>CI</i>:1.39-20.14) were at a higher risk of disease progression. Patients with EB viral load≥1 000 copies/ml (<i>HR</i>=0.07, 95%<i>CI</i>:0.05-0.93) on the RCHOP regimen had a small risk of disease progression. Males (<i>HR</i>=2.87, 95%<i>CI</i>:1.65-9.17), EB viral load≥1 000 copies/ml (<i>HR</i>=1.61, 95%<i>CI</i>:4.02-9.36), HIV-RNA≥200 copies/ml (<i>HR</i>=1.19, 95%<i>CI</i>:1.58-2.74), ECOG PS score of 2 to 4 (<i>HR</i>=6.42, 95%<i>CI</i>:2.55-14.33), IPI score of 3 to 5 points (<i>HR</i>=2.78, 95%<i>CI</i>:1.41-12.96) had a high risk of mortality. Patients with EB viral load≥1 000 copies/ml (<i>HR</i>=0.24, 95%<i>CI</i>:0.64-0.90) on the RCHOP regimen had a low risk of mortality. In summary, males, ECOG physical status score of 2 to 4 points, IPI score of 3 to 5 points, EB viral load≥1 000 copies/ml and HIV viral load≥200 copies/ml are risk factors affecting progression-free survival and overall survival of AIDS-DLBCL patients. RCHOP regimen combined with EB viral load≥1 000 copies/ml is a protective factor affecting progression-free survival and overall survival in AIDS-DLBCL patients.</p>","PeriodicalId":24033,"journal":{"name":"中华预防医学杂志","volume":"58 ","pages":"1548-1555"},"PeriodicalIF":0.0000,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[Clinical features and prognostic factors of AIDS-associated diffuse large B-cell lymphoma].\",\"authors\":\"W Luo, Q H Ma, L Y He, H C Wang, F L Wu, J W Hu, Y Wu, T Tao\",\"doi\":\"10.3760/cma.j.cn112150-20240422-00332\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>To explore the general clinical features and treatment outcomes of patients with AIDS-related diffuse large B-cell lymphoma (AIDS-DLBCL) and provide a theoretical basis for diagnosis and treatment, survival prognosis, prevention and management of AIDS-DLBCL patients. AIDS-DLBCL patients who received combined antiretroviral therapy (cART) at Changsha First Hospital from January 2017 to January 2020 were selected in this study. The survival curves were plotted using the Kaplan-Meier method, and the Cox proportional hazards regression model was used to analyze the association between AIDS-DLBCL specific variables and progression-free survival and overall survival. Correlation analysis was conducted based on the clinical features of the patients. A total of 50 AIDS-DLBCL patients were included. Their median age (<i>Q<sub>1</sub>, Q<sub>3</sub></i>) was 52 (44, 59) years, of whom 46 (92%) were male. About 20 (40%) patients received treatment with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), while 23 patients (46%) received treatment with rituximab combined with cyclophosphamide, doxorubicin, vincristine, and prednisone (RCHOP). Survival curve analysis showed that the 2-year progression-free survival rate and overall survival rate of AIDS-DLBCL patients were 56.9% and 61.6%, respectively. Patients with RCHOP protocol combined with EBV-DNA≥1 000 copies/ml had higher progression-free survival rate (χ<sup>2</sup>=3.844, <i>P</i>=0.043) and overall survival rate (χ<sup>2</sup>=4.662, <i>P</i>=0.031) than those with CHOP protocol combined with EBV-DNA≥1 000 copies/ml. A multivariate analysis showed that male (<i>HR</i>=2.70, 95%<i>CI</i>:1.10-6.80), EB viral load≥1 000 copies/ml (<i>HR</i>=1.75, 95%<i>CI</i>:1.12-2.84), HIV-RNA≥200 copies/ml (<i>HR</i>=4.64, 95%<i>CI</i>: 1.73-12.15), ECOG PS score of 2 to 4 points (<i>HR</i>=3.54, 95%<i>CI</i>:1.62-7.33), and international prognostic index (IPI) score of 3 to 5 points (<i>HR</i>=5.21, 95%<i>CI</i>:1.39-20.14) were at a higher risk of disease progression. Patients with EB viral load≥1 000 copies/ml (<i>HR</i>=0.07, 95%<i>CI</i>:0.05-0.93) on the RCHOP regimen had a small risk of disease progression. Males (<i>HR</i>=2.87, 95%<i>CI</i>:1.65-9.17), EB viral load≥1 000 copies/ml (<i>HR</i>=1.61, 95%<i>CI</i>:4.02-9.36), HIV-RNA≥200 copies/ml (<i>HR</i>=1.19, 95%<i>CI</i>:1.58-2.74), ECOG PS score of 2 to 4 (<i>HR</i>=6.42, 95%<i>CI</i>:2.55-14.33), IPI score of 3 to 5 points (<i>HR</i>=2.78, 95%<i>CI</i>:1.41-12.96) had a high risk of mortality. Patients with EB viral load≥1 000 copies/ml (<i>HR</i>=0.24, 95%<i>CI</i>:0.64-0.90) on the RCHOP regimen had a low risk of mortality. In summary, males, ECOG physical status score of 2 to 4 points, IPI score of 3 to 5 points, EB viral load≥1 000 copies/ml and HIV viral load≥200 copies/ml are risk factors affecting progression-free survival and overall survival of AIDS-DLBCL patients. RCHOP regimen combined with EB viral load≥1 000 copies/ml is a protective factor affecting progression-free survival and overall survival in AIDS-DLBCL patients.</p>\",\"PeriodicalId\":24033,\"journal\":{\"name\":\"中华预防医学杂志\",\"volume\":\"58 \",\"pages\":\"1548-1555\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-10-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"中华预防医学杂志\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3760/cma.j.cn112150-20240422-00332\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"中华预防医学杂志","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3760/cma.j.cn112150-20240422-00332","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
[Clinical features and prognostic factors of AIDS-associated diffuse large B-cell lymphoma].
To explore the general clinical features and treatment outcomes of patients with AIDS-related diffuse large B-cell lymphoma (AIDS-DLBCL) and provide a theoretical basis for diagnosis and treatment, survival prognosis, prevention and management of AIDS-DLBCL patients. AIDS-DLBCL patients who received combined antiretroviral therapy (cART) at Changsha First Hospital from January 2017 to January 2020 were selected in this study. The survival curves were plotted using the Kaplan-Meier method, and the Cox proportional hazards regression model was used to analyze the association between AIDS-DLBCL specific variables and progression-free survival and overall survival. Correlation analysis was conducted based on the clinical features of the patients. A total of 50 AIDS-DLBCL patients were included. Their median age (Q1, Q3) was 52 (44, 59) years, of whom 46 (92%) were male. About 20 (40%) patients received treatment with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), while 23 patients (46%) received treatment with rituximab combined with cyclophosphamide, doxorubicin, vincristine, and prednisone (RCHOP). Survival curve analysis showed that the 2-year progression-free survival rate and overall survival rate of AIDS-DLBCL patients were 56.9% and 61.6%, respectively. Patients with RCHOP protocol combined with EBV-DNA≥1 000 copies/ml had higher progression-free survival rate (χ2=3.844, P=0.043) and overall survival rate (χ2=4.662, P=0.031) than those with CHOP protocol combined with EBV-DNA≥1 000 copies/ml. A multivariate analysis showed that male (HR=2.70, 95%CI:1.10-6.80), EB viral load≥1 000 copies/ml (HR=1.75, 95%CI:1.12-2.84), HIV-RNA≥200 copies/ml (HR=4.64, 95%CI: 1.73-12.15), ECOG PS score of 2 to 4 points (HR=3.54, 95%CI:1.62-7.33), and international prognostic index (IPI) score of 3 to 5 points (HR=5.21, 95%CI:1.39-20.14) were at a higher risk of disease progression. Patients with EB viral load≥1 000 copies/ml (HR=0.07, 95%CI:0.05-0.93) on the RCHOP regimen had a small risk of disease progression. Males (HR=2.87, 95%CI:1.65-9.17), EB viral load≥1 000 copies/ml (HR=1.61, 95%CI:4.02-9.36), HIV-RNA≥200 copies/ml (HR=1.19, 95%CI:1.58-2.74), ECOG PS score of 2 to 4 (HR=6.42, 95%CI:2.55-14.33), IPI score of 3 to 5 points (HR=2.78, 95%CI:1.41-12.96) had a high risk of mortality. Patients with EB viral load≥1 000 copies/ml (HR=0.24, 95%CI:0.64-0.90) on the RCHOP regimen had a low risk of mortality. In summary, males, ECOG physical status score of 2 to 4 points, IPI score of 3 to 5 points, EB viral load≥1 000 copies/ml and HIV viral load≥200 copies/ml are risk factors affecting progression-free survival and overall survival of AIDS-DLBCL patients. RCHOP regimen combined with EB viral load≥1 000 copies/ml is a protective factor affecting progression-free survival and overall survival in AIDS-DLBCL patients.
期刊介绍：
Chinese Journal of Preventive Medicine (CJPM), the successor to Chinese Health Journal , was initiated on October 1, 1953. In 1960, it was amalgamated with the Chinese Medical Journal and the Journal of Medical History and Health Care , and thereafter, was renamed as People’s Care . On November 25, 1978, the publication was denominated as Chinese Journal of Preventive Medicine . The contents of CJPM deal with a wide range of disciplines and technologies including epidemiology, environmental health, nutrition and food hygiene, occupational health, hygiene for children and adolescents, radiological health, toxicology, biostatistics, social medicine, pathogenic and epidemiological research in malignant tumor, surveillance and immunization.
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