To investigate the clinical characteristics, treatment and prognosis of patients with human immunodeficiency virus (HIV) infection and Burkkit lymphoma.

The clinical data of HIV-positive patients with Burkkit lymphoma from December 2010 to June 2021 in Beijing Ditan hospital, Capital Medical University were collected. The disease features, treatment regimens and prognosis were analyzed. And the prognostic factors were evaluated by multivariable Cox proportional hazards model.

Total of 179 HIV-positive patients with Burkkit lymphoma were enrolled consecutively. The frequency of Burkkit lymphoma was 31.8% (57/179), of whom 46 cases were diagnosed by histology and 11 cases were diagnosed by cytology. Three patients were primary central nervous Burkkit lymphoma, the others were diagnosed as non-primary central nervous Burkkit lymphoma, of whom 41 patients were diagnosed with Ann Arbor stage Ⅲ/Ⅳ. Median age was 43 years (21-60 years old). There were 27 cases (47.4%) with baseline median absolute CD4⁺ T < 200 cells/μl. Five patients could not be treated due to liver and kidney failure or severe infection, and 4 patients were lost to follow-up. And the rest 45 patients with non-primary central nervous Burkkit lymphoma received systemic chemotherapy with or without rituximab. The 45 patients received CODOX-M (cyclophosphamide, vincristine, doxorubixin, dexamethasone-MTX)/IVAC ± R (ifosfamide, cytarabine, etoposide ± rituximab) or EPOCH-R (etoposide, prednison, vincristine, cyclophosphamide, doxorubixin-rituximab) treatment. The complete response rate was 37.8% (17/45). The median overall survival was 16.0 months (95%CI: 12.4-19.6). The primary extral nodal organ disease was defined as an adverse prognostic factor (HR = 10.18, 95%CI: 2.48-41.73, P = 0.001).

Most patients with HIV infection combined with Burkkit lymphoma are in the advanced stage of the disease when diagnosed, which partially lose the opportunity of treatment, and the prognosis is poor. More effective and low-toxicity treatment options need to be explored.