Abstract:

Objective

To investigate the clinical features and prognostic trends of acquired immunodeficiency syndrome （AIDS）-related lymphoma （ARL）.

Methods

Total of 53 patients with ARL diagnosed and treated in Zhongnan Hospital of Wuhan University from January 2006 to December 2015 were selected as control group， due to the improvement of the anti-tumor regimen for ARL patients since 2016，97 patients with ARL diagnosed and treated in our hospital from January 2016 to December 2022 were selected as research group. Pearson Chi-square test or Fisher’s exact probability method were used to compare the clinical characteristics， including non-Hodgkin lymphoma （NHL） pathological classification， Ann Arbor stage， central involvement and bone marrow involvement， etc， and survival status between the two groups.

Results

Compared with control group， patients in research group were older ［（48.81 ± 12.50） years old vs. （43.13 ±12.75） years old：t = 2.65， P = 0.010］， and the proportion of patients with clinical stage Ⅲ-Ⅳ was higher （81.44%vs. 54.72%：χ² = 13.722， P ＜ 0.001）， international prognostic index （IPI） score was poorer （proportion of 3-5 points：84.53% vs. 66.04%：χ² = 7.495， P = 0.024）， proportion of bone marrow involvement was higher （46.39%vs. 28.30%：χ² = 4.673， P = 0.031） and the pathological classification of lymphoma changed significantly （P = 0.003）［the proportion of Burkitt lymphoma （BL） patients increased significantly （37.11% vs. 9.43%）， the proportion of diffuse large B-cell lymphoma decreased （44.33% vs. 67.92%）］； There were no significant differences in gender， CD4⁺ T cell count， central nervous system involvement， ARL treatment and highly active antiretroviral therapy （HAART） between the two groups （all P ＞ 0.05）. Total of 93 ARL patients （55 cases in research group and 38 cases in control group） died during the follow-up period， and the follow-up time was 11.21（4.00， 29.25） months. The follow-up time of research group and control group were 10.0 （4.50， 24.50） months and 7.0 （2.0， 112.0） months， respectively （Z = 0.11， P = 0.910）. The one-year overall survival （OS） rates of research group and control group were 54.64% and 41.51%， respectively （χ² = 2.363， P = 0.124）. The oneyear OS rates of patients who received oncotherapy were 69.33% and 60.0% （χ² = 0.931， P = 0.335）， and the one-year OS rates of patients who did not receive oncotherapy were 4.55% and 5.56% （P ＞ 0.999）， all without significant differences. Tumor progression was the main cause of death in research group and control group，up to 81.82% （45/55） and 81.58% （31/38）， respectively.

Conclusions

In recent years， the onset age of ARL patients is delayed， the proportion of BL is significantly increased， the clinical stage of ARL is worse， and it is more urgent to explore more effective treatment methods.

Key words: Acquired immune deficiency syndrome, Non-Hodgkin lymphoma, Clinical characteristics, Overall survival, Oncotherapy