Clinical Features, Phenotypic Markers and Outcomes of Diffuse Large B-Cell Lymphoma between HIV-Infected and HIV-Uninfected Chinese Patients

Abstract

Background: The effect of HIV infection on the clinicopathological characteristics of diffuse large B-cell lymphoma (DLBCL) remains debatable. Methods: Fifty-three HIV-infected and ninety-three HIV-uninfected DLBCL patients were enrolled in the retrospective study by propensity score matching for sex, age, body mass index and international prognostic index (IPI) at a ratio of 1:2. The clinicopathological characteristics were compared between the two groups. Results: HIV-infected DLBCL patients had lower white blood cell counts [×109/L; 4.4(3.4–5.6) vs. 6.1(4.2–8.2), p < 0.001], platelet counts ((×109/L; 184.7 ± 89.3 vs. 230.0 ± 113.9, p = 0.014) and serum albumin (g/L; 37.3 ± 6.9 vs. 41.3 ± 6.2, p < 0.001) but higher incidences of central nervous system (CNS) involvement (9.4% vs. 1.1%, p = 0.014), bone marrow involvement (24.5% vs. 11.5%, p = 0.044) and Epstein–Barr viremia (61.1% vs. 26.7%, p = 0.002) than HIV-uninfected patients. In terms of histopathology, HIV-infected patients had higher positivity of Epstein–Barr virus-encoded small RNA (EBER) (41.7% vs. 6.7%, p = 0.002), but lower CD20 (90.2% vs. 98.7%, p= 0.029) and CD79a (23.1% vs. 53.7%, p < 0.001) expression. The overall response rate (ORR) at the end of chemotherapy (70.2% vs. 87.8%, p= 0.012) and 1-year overall survival (OS) (61.7% vs. 84.2%, log-rank p = 0.006) in HIV-infected patients were significantly lower than those in HIV-uninfected patients. Multivariate analysis suggested IPI ≤2.0 [adjusted odds ratio (AOR) (95% confidence interval): 5.0 (1.2–21.2), p = 0.030] was associated with ORR, hypoalbuminemia [AOR: 3.3(1.3–9.1), p = 0.018] and CNS involvement [AOR: 3.3(1.0–10.5), p = 0.044] were associated with reduced 1-year OS in HIV-infected patients. Conclusions: HIV-infected DLBCL patients have unique blood profiles and phenotypic markers. Low ORR and 1-year OS were observed in HIV-infected DLBCL patients in our study, even in the HAART era.

Baseline Serum Cholinesterase Levels Predict the Outcome of HIV-Related Diffuse Large B-Cell Lymphoma

“…Previous studies have shown that persistent in ammation and malnutrition are both associated with unfavorable outcomes in patients with HIV-related DLBCL [13][14][15] . Given that CHE is an important indicator of chronic in ammation and malnutrition, we hypothesize that serum CHE levels may be associated with the progression and prognosis of HIV-related DLBCL.…”

Application of New Molecular Probes in the Diagnosis and Treatment of Malignant Tumors

“…Zhou et al explore the clinical features, phenotypic markers, and outcomes of diffuse large B-cell lymphoma (DLBCL) in HIV-infected and HIV-uninfected Chinese patients. The results indicate that HIV-infected DLBCL patients exhibit distinct blood and phenotypic markers, with lower response rates and one-year survival rates, likely due to increased hematological complications and widespread organ involvement [6]. Also, another study in this Special Issue suggests that TFF1 and TFF2 may function as potential tumor suppressors in Gastric cancer (GC), offering valuable insights for predicting overall survival (OS) in GC patients.…”