HIV相关弥漫大B细胞淋巴瘤患者临床特征及预后分析  

The clinical and prognosis features of HIV-associated diffuse large B-cell lymphoma patients

作　　者：吕茹 李政杰 叶子 魏洪霞[1] 成骢[1] LU Ru;LI Zhengjie;YE Zi;WEI Hongxia;CHENG Cong(Department of Infectious Diseases,The Second Hospital of Nanjing,Nanjing 210000,China)

机构地区：[1]南京市第二医院感染性疾病科,江苏南京210000

出　　处：《东南大学学报(医学版)》2025年第2期293-299,共7页Journal of Southeast University(Medical Science Edition)

基　　金：2020年江苏省卫生健康委医学科研项目(ZDA2020014);南京市医学科技发展重点项目(ZKX22040)。

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 stageⅢ-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.

关 键 词：艾滋病 人类免疫缺陷病毒 弥漫大B细胞淋巴瘤 预后 临床特征 

分 类 号：R512.91[医药卫生—内科学]