人类免疫缺陷病毒相关霍奇金淋巴瘤22例临床分析

Human immunodeficiency virus-associated Hodgkin lymphoma:a clinical analysis of 22 cases

目的探讨人类免疫缺陷病毒(HIV)相关霍奇金淋巴瘤患者的临床特征、疗效及预后。方法回顾性病例系列研究。回顾性分析2013年12月至2022年6月重庆大学附属肿瘤医院诊治的22例HIV相关霍奇金淋巴瘤患者临床资料,分析其临床特征、实验室检查结果、治疗情况及预后。采用Kaplan-Meier法进行生存分析。结果22例患者年龄[M(Q1,Q3)]44岁(36岁,53岁);男性18例,女性4例;临床分期Ⅲ期5例,Ⅳ期17例。22例患者均通过性传播感染HIV,其中10例通过男男性传播感染,12例通过异性性传播感染。9例为诊断淋巴瘤时发现感染HIV,13例确诊感染HIV 22.2个月(12.3个月,38.4个月)后发现淋巴瘤。22例患者中,3例放弃治疗;19例患者采用抗反转录病毒治疗联合ABVD方案化疗,其中9例完全缓解,10例部分缓解。随访46.8个月(24.8个月,64.5个月),5年无进展生存率为83.9%,5年总生存率为89.5%。结论HIV相关霍奇金淋巴瘤患者临床呈侵袭性过程,规范的抗反转录病毒治疗联合ABVD方案化疗可使患者获得长期生存。

Objective To investigate the clinical characteristics,therapeutic efficacy and prognosis of patients with human immunodeficiency virus(HIV)-associated Hodgkin lymphoma.Methods A retrospective case series study was conducted.The clinical data of 22 HIV-associated Hodgkin lymphoma patients in Chongqing University Cancer Hospital from December 2013 to June 2022 were retrospectively analyzed.Their clinical features,laboratory results,treatment,and prognosis were analyzed.Kaplan-Meier method was used to perform survival analysis.Results The age[M(Q 1,Q 3)]of 22 patients was 44 years old(36 years old,53 years old);18 cases were male,4 cases were female;clinical staging was stageⅢin 5 patients and stageⅡin 17 patients.All 22 patients were infected with HIV through sexual transmission,with 10 cases transmitted through man sex with man and 12 cases transmitted through heterosexual transmission.Nine patients were found to be infected with HIV at the time of diagnosis of lymphoma,and 13 patients presented with lymphoma at 22.2 months(12.3 months,38.4 months)after diagnosis of HIV infection.Of the 22 patients,3 abandoned treatment;19 patients were treated with antiretroviral therapy combined with ABVD regimen chemotherapy,9 patients had complete remission,and 10 patients had partial remission.After follow-up of 46.8 months(24.8 months,64.5 months),the 5-year progression-free survival rate was 83.9%,and the 5-year overall survival rate was 89.5%.Conclusions HIV-associated Hodgkin lymphoma exhibits an invasive process in clinical practice,and standardized antiretroviral therapy combined with ABVD regimen chemotherapy can lead to long-term survival for patients.