How I treat lymphomas associated with HIV infection

TL;DR

This paper discusses treatment approaches for lymphomas in HIV-infected patients, emphasizing the importance of combined therapies and new drug trials.

Contribution

The paper proposes a standardized treatment pathway and references new drug applications for HIV-related lymphomas.

Findings

Combining cART with targeted immunotherapy and early stem cell transplantation improves long-term survival.

New drugs like XPO1 inhibitors and immune checkpoint inhibitors show initial clinical promise.

Standardized treatment protocols are needed to improve outcomes for HIV-related lymphoma patients.

Abstract

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。

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