A national, multicenter, retrospective study of human immunodeficiency virus infection-associated lymphoma in China

Since the widespread use of combination antiretroviral therapy, the incidence of opportunistic infections has decreased in HIV infection populations. However, HIV-associated lymphoma become the most common causes of cancer death. Little is known about the epidemiology, survival and treatment of HIV-associated lymphoma patients in China as these are less common than HIV-negative lymphoma. We performed a multi-center retrospectively study to analyze the epidemiology, clinical characteristics and outcomes of HIV-associated lymphoma in China. Totally 407 newly diagnosed HIV-associated lymphoma patients at eleven medical centers from July 2008 to October 2021, were analyzed, as the largest cohort reported in China to date. In the entire cohort, including 373 (91.6%) B-cell lymphoma, 19 (4.7%) HL patients, and 11 (2.7%) T-cell lymphoma. Among B-cell lymphoma, DLBCL was the most common (n = 273, 73.2%), followed by BL (n = 47, 12,6%). The median age was 47 years (range, 18-90) at lymphoma diagnosis, and 332 patients were male (81.6%), 254 patients (62.4%) were diagnosed with advanced stage (III/IV). In the entire cohort, 57 (14.0%) patients did not receive anti-lymphoma treatment, 350 patients (86.0%) underwent chemotherapy as part of their first-line treatment. More than half of them (241/350, 68.9%) had underwent 4 cycles or more of chemotherapy. The median follow-up of our cohort was 65 (36-186) months. The estimated 5-year OS rates in the HL and NHL cohort were 83.6% and 50.9%, respectively. The 5-year OS rates demonstrated an inverse correlation with ART duration prior to lymphoma diagnosis: 65.4% for patients not receiving ART before lymphoma diagnosis, 54.2% for those on ART for less than 12 months, and 42.8% for those on ART for ≥ 12 months (p = 0.014). This study depicts a broad picture of HIV-associated lymphoma, treatment options and survival information in China. These data suggested that HIV-associated lymphoma patients presented with aggressive clinical characteristics and rituximab, enhanced chemotherapy administration and shorter ART duration before lymphoma diagnosis was significantly associated with improved outcomes.