HIV相关弥漫大B细胞淋巴瘤患者临床特征及预后分析-东南大学学报医学版

HIV相关弥漫大B细胞淋巴瘤患者临床特征及预后分析

单位：南京市第二医院感染性疾病科, 江苏南京 210000

分类号：R512.91

出版年·卷·期（页码）：2025·44·第二期（293-299）

摘要：

目的:探讨人类免疫缺陷病毒(HIV)相关弥漫大B细胞淋巴瘤(DLBCL)患者的临床特征及影响患者预后的危险因素。方法:回顾性收集2016年8月至2024年5月在我院诊断为HIV相关DLBCL患者(n=72)的临床数据及随访资料。通过单因素及多因素Cox风险回归模型预测HIV相关DLBCL患者1年和3年总体生存(OS)的危险因素。结果:72例患者诊断为HIV相关DLBCL时的平均年龄为(50.6±13.9)岁,其中男63例,女9例。DLBCL原发灶为淋巴结外的患者50例(69.4%),伴B症状46例(63.9%),EB病毒感染阳性55例(87.3%)。确诊时52例患者已发生转移(72.2%),57例为Ⅲ~Ⅳ期(79.2%)。HIV相关DLBCL患者的1年和3年生存率分别为47.2%和43.1%。多因素Cox风险回归模型结果表明,高CD4⁺T淋巴细胞计数及化疗联合抗逆转录病毒治疗(cART)是HIV相关DLBCL患者1年和3年OS的独立保护因素。结论:HIV相关DLBCL患者确诊时多为晚期,高CD4⁺T淋巴细胞数量及cART可显著提高HIV相关DLBCL患者的1年和3年OS。

Objective: To explore the clinical features and risk factors of human immunodeficiency virus(HIV)-associated diffuse large B-cell lymphoma(DLBCL). Methods: Clinical and follow-up data of patients diagnosed with HIV-associated DLBCL in our hospital from August 2016 to May 2024(n=72) were retrospectively collected. Univariate and multivariate Cox risk regression models were used to predict 1-year and 3-year overall survival(OS) in HIV-associated DLBCL patients. Results: The average age of 72 patients(63 males and 9 females) collected was 50.6±13.9 years. There were 50 patients(69.4%) with extranodal DLBCL, 46 patients(63.9%) with B symptoms, and 55 patients(72.2%) with positive Epstein-Barr virus infection. 52 patients had metastases at diagnosis(72.2%), and 57 patients were stage Ⅲ-Ⅳ(79.2%). The 1-year and 3-year survival rates for HIV-associated DLBCL patients were 47.2% and 43.1%, respectively. Multivariate Cox risk regression model results showed that high CD4⁺T cell count and combined antiretroviral therapy(cART) were independent protective factors for 1-year and 3-year OS in HIV-associated DLBCL patients. Conclusion: HIV-associated DLBCL patients are mostly diagnosed in the advanced stage. High CD4⁺T lymphocyte count and cART could significantly prolong the 1-year and 3-year OS of HIV-associated DLBCL patients.

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