我如何治疗人类免疫缺陷病毒感染相关淋巴瘤  

How I treat lymphomas associated with HIV infection

作　　者：刘耀 王超雨 Liu Yao;Wang Chaoyu(Hematology-Oncology Center,Chongqing University Cancer Hospital,Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment,Chongqing 400030,China)

机构地区：[1]重庆大学附属肿瘤医院血液肿瘤中心,肿瘤转移与个体化诊治转化研究重庆市重点实验室,重庆400030

出　　处：《中华血液学杂志》2025年第2期120-125,共6页Chinese Journal of Hematology

摘　　要：人类免疫缺陷病毒(HIV)感染相关淋巴瘤总体发病率低,且可规范收治该类疾病的血液肿瘤专科较少。对于初诊患者,由于获得性免疫缺陷综合征背景下患者免疫功能受损,诱导治疗过程中感染等并发症发生率高,治疗难度增大;对于复发/难治患者,由于缺乏相应的新药临床研究,故挽救治疗方案极其有限。目前国内外临床实践显示,对于HIV感染相关淋巴瘤患者,规范抗逆转录病毒治疗(cART)联合靶向免疫化疗获得完全缓解后尽早行自体造血干细胞移植可使患者获得长期生存。近年来,一些新药(如XPO1抑制剂、免疫检查点抑制剂、抗体药物偶联物、双抗、小分子药物)也尝试加入HIV感染相关淋巴瘤患者的整体治疗方案中并获得了初步的临床数据。本文从本中心收治的2例HIV感染相关淋巴瘤患者出发,提出规范化诊治路径,并在新药应用方面为临床医师提供相应参考,以提升我国HIV感染相关淋巴瘤诊疗水平,提高患者的生存率及生活质量。The overall incidence of lymphomas associated with HIV infection is low,and only few hematological oncology specialties provide standardized treatment.Newly diagnosed patients with impaired immune function have a high incidence of complications,such as infections during induction chemotherapy,which increases treatment difficulties.For patients with relapse/refractory status,salvage treatment options are extremely limited,because new drug clinical trials are lacking.At present,both domestic and international clinical practices have shown that patients with lymphomas associated with HIV infection can achieve long-term survival after standardized combination antiretroviral therapy(cART)with targeted immunochemotherapy,followed by autologous hematopoietic stem cell transplantation(auto-HSCT)immediately after achieving complete remission.In recent years,some new drugs,such as XPO1 inhibitors,immune checkpoint inhibitors,antibody-drug conjugates(ADC drugs),bispecific antibodies,and small-molecule drugs,have been tentatively incorporated into treatment regimens for patients with lymphomas associated with HIV infection,and preliminary clinical data have been obtained.Based on two patients with lymphomas associated with HIV infection who were admitted to our center,this study proposed a standardized diagnostic and treatment pathway and provided corresponding references for clinicians to apply new drugs.The aim of this study was to promote diagnostic and treatment capabilities and improve the survival and quality of life of patients of lymphomas associated with HIV infection in China.

关 键 词：HIV感染 诱导治疗 淋巴瘤 靶向免疫化疗 自体造血干细胞移植 

分 类 号：R733.1[医药卫生—肿瘤]