艾滋病合并浆母细胞淋巴瘤7例临床分析

AIDS complicated with plasmablastic lymphoma:Clinical analysis of 7 cases

目的探讨艾滋病合并浆母细胞淋巴瘤(Plasmablastic lymphoma,PBL)的临床特点,为临床治疗提供参考。方法回顾性分析2016年1月至2022年10月云南省传染病医院收治的7例艾滋病合并PBL患者的临床特征及实验室检查结果。采用Excel对数据进行处理。结果男性患者6例,女性1例,中位年龄48岁(41~56岁)。所有患者均为口腔颌面受累起病,初诊Ann Arbor分期仅1例为Ⅱ期,其余6例为Ⅲ期及以上。6例患者存在全身症状。所有患者Ki-67增殖指数均大于80%,且全部表达MYC基因重排,6例患者EBER为阳性。7例患者均接受了DA-EPOCH为基础的一线化疗及抗反转录病毒治疗(Antiretroviral therapy,ART)。5例患者在启动化疗的同时启动了ART,另外2例患者启动ART早于化疗。4例患者在化疗后经PET-CT评估达到完全缓解,3例死亡。结论积极化疗联合ART治疗可使艾滋病合并PBL患者获益最大化;在第1个化疗周期内引入ART,可避免患者出现肿瘤快速恶化。

Objective To analyze the clinical characteristics of AIDS complicated with plasmablastic lymphoma(PBL).Methods Clinical data and laboratory test of 7 AIDS patients complicated with PBL admitted to Yunnan Infectious Disease Hospital from January 2016 to October 2022 were retrospectively analyzed.Results There were 6 male patients and 1 female patient with a median age of 48 years(41-56 years).All patients had oral and maxillofacial involvement,and only 1 case was stageⅡat the initial Ann Arbor stage,while 6 cases were stageⅢor higher.Six patients had systemic symptoms.All patients had a Ki-67 proliferation index greater than 80%and all presented MYC gene rearrangements,and 6 patients were positive for EBER.All patients received DA-EPOCH-based first-line chemotherapy and antiretroviral therapy(ART),Five patients initiated ART at the same time as chemotherapy,and 2 patients initiated ART before chemotherapy.Four patients achieved complete remission after chemotherapy according to PET-CT evaluation,and 3 patients died.Conclusions Active chemotherapy combined with ART can maximize the therapeutic benefits of AIDS patients with PBL.The introduction of ART in the first chemotherapy cycle can avoid the rapid disease deterioration in the patients.