[Human immunodeficiency virus and lymphoma]

Application effect of 18F-FDG PET/CT technique in diagnosis and prognosis evaluation of lymphoma

The objective of the study was to research diagnostic and prognostic values of 18F fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) in patients with diffuse large B-cell lymphoma (DLBCL). The diagnostic sensitivity (Sen) of PET/CT (94.75 %) was remarkably higher than 83.56 % of B-US. Age ≥ 65 years old, maximum focal diameter ≥5 cm, clinical stages III-IV, systemic symptoms, increased lactate dehydrogenase level, high modified international prognostic index score, Ecog score ≥1, B-cell lymphoma 2 (Bcl-2) gene, MYC protein expression rate, metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were all factors that influenced the recurrence or progression of DLBCL. With higher MTV and TLG, patients would have a greater probability of recurrence or progression. 18F-FDG PET/CT showed a high diagnostic Sen in lymphoma lesions, and could accurately guide clinical staging. Combined with clinical parameters, laboratory indicators, and metabolic parameters, prognostic indicators of patients could be evaluated more accurately.

Prognostic value of nutritional status in patients with human immunodeficiency virus infection-related lymphoma

Objective

To investigate the predictive value of nutritional status on the prognosis of patients with human immunodeficiency virus (HIV) infection-related lymphoma.

Materials and methods

A total of 149 patients with HIV infection-related lymphoma who were admitted to our hospital from August 2012 to May 2022 were selected as research subjects. Based on the patient prognosis, they were divided into a poor prognosis group (n = 30) and a good prognosis group (n = 119). General data from patients in both groups were collected, and the nutritional status of the patients was evaluated using the Controlling Nutritional Status (CONUT) score. Factors affecting the prognosis of HIV infection-related lymphoma were analyzed using univariate and multivariate analyses, and a prediction model was developed based on the analyzed factors. The receiver operating characteristic (ROC) curve was used to analyze the prediction model of the CONUT score alone and included the CONUT score in the prognosis of patients with HIV infection-related lymphoma. The predictive value of the data was assessed, and a survival curve was drawn to compare the survival of patients with different nutritional statuses.

Results

There were significant differences in age, B symptoms, treatment conditions, International Prognostic Index (IPI), pathological stage, Eastern Collaborative Tumor Group physical status score (ECOG PS), CD4+ cell count, β2 microglobulin, and lactate dehydrogenase (LDH) between the poor prognosis group and the good prognosis group (p < 0.05). The CONUT score of the poor prognosis group was higher than that of the good prognosis group, and the difference was statistically significant (p < 0.05). A univariate analysis demonstrated that the age, B symptoms, treatment status, IPI, pathological stage, ECOG PS, CD4+ cell count, β2 microglobulin, LDH, and CONUT score were prognostic factors for patients with HIV infection-related lymphoma (p < 0.05). The results of a multivariate regression analysis demonstrated that the age, B symptoms, treatment status, IPI, pathological stage, ECOG PS, and CONUT score were independent risk factors for the prognosis of patients with HIV infection-related lymphoma (p < 0.05). The prediction model was constructed according to the multivariate Cox regression analysis results. The model formula was as follows: Logit(p) = −10.687 + 1.728 × age + 1.713 × B symptoms + 1.682 × treatment status + 1.810 × IPI + 1.643 × pathological stage + 1.584 × ECOG PS + 1.779 × CONUT score. The ROC curve was used to analyze the predictive value of the CONUT score alone and the predictive model including the CONUT score on the prognosis of patients with HIV infection-related lymphoma. The predictive value of the prognosis of patients with tumors was higher (p < 0.05). According to the results of the ROC curve analysis, the patients were divided into a high CONUT group (CONUT > 6.00 points, n = 31) and a low CONUT group (CONUT ≤ 6.00 points, n = 118) based on the Optimum threshold of the CONUT score. The survival curve showed that the survival rate of the high CONUT group was lower than that of the low CONUT group (p < 0.05).

Conclusion

The poor prognosis of HIV infection-related lymphoma is related to nutritional status, which is an independent risk factor affecting the prognosis of patients and can be used as a practical indicator to predict the prognosis of patients.

A Rare Case of Plasmablastic Lymphoma in a Patient with HIV and SARS-CoV-2 Infections

Lesions commonly associated with HIV infection include oral candidiasis, herpes simplex infection, oral Kaposi’s sarcoma, hairy leukoplakia, periodontal diseases (linear gingival erythema and necrotizing ulcerative periodontitis), xerostomia, human papillomavirus-associated warts, aphthous ulcers, non-Hodgkin’s lymphoma, histoplasmosis, carcinoma, exfoliative cheilitis, and HIV salivary gland disease. Non-Hodgkin’s lymphoma (NHL) is the most common cancer in people living with HIV (PLWH), and the incidence is increased for aggressive B-cell NHL. Plasmablastic lymphoma (PbL) is a rare and aggressive B-cell malignancy that is often unresponsive to chemotherapy and usually has a poor prognosis. We hereby present the case of a patient with a recent history of COVID-19 infection who was diagnosed with HIV and NHL, with manifestations in the oral cavity and a favorable evolution after the introduction of antiviral therapy, specific chemotherapy, and radiotherapy. Dental expertise is necessary for the appropriate management of oral manifestations of HIV infection or AIDS, and lymphoma should be included in the differential diagnosis of any oral lesions.