艾滋病（AIDS）患者相较于普通人群，其非霍奇金淋巴瘤（NHL）的发生风险显著增高。为促进学界对艾滋病相关性淋巴瘤（ARL）的深入了解及规范化诊疗，在近期召开的第29届欧洲血液学协会（EHA）年会上，特别设置了“ARL：EHA-ESMO临床实践指南”专场。《肿瘤瞭望-血液时讯》特邀该专场主席、克罗地亚萨格勒布大学医院中心和医学院Igor Aurer教授接受采访，介绍ARL的发病机制、治疗挑战、指南更新要点以及临床实用建议，并对明年的EHA会议及血液学领域进展做出展望。

 

Dr.Igor Aurer：HIV患者以及其他免疫缺陷患者更频繁地患上淋巴瘤，其根本原因在于他们的免疫系统受损。在这种情况下，他们无法有效控制慢性病毒感染，如EB病毒（Epstein-Barr virus）或巨细胞病毒（Cytomegalovirus，CMV），这显著增加了风险。此外，对于HIV患者来说，病毒直接插入淋巴细胞基因组的现象也进一步促进了淋巴瘤的发展。

 

Oncology Frontier-Hematology Frontier：Dr.Aurer，considering your extensive experience，can you explain why patients with HIV infection are at a higher risk of developing lymphomas compared to otherwise healthy individuals?

 

Dr.Igor Aurer:The fundamental reason patients with HIV，as with other immunodeficiencies，develop lymphomas more frequently is due to their compromised immune system.This inability to effectively manage chronic viral infections，such as Epstein-Barr virus(EBV)or cytomegalovirus(CMV)，significantly increases the risk.Additionally，in the case of HIV，there is also the direct insertion of the virus into the genome of lymphocytes，further contributing to the development of lymphomas.

 

Dr.Igor Aurer：大约两年前，我们启动了一个旨在更新HIV相关淋巴瘤治疗建议的项目。这些更新至关重要，因为它们反映了该领域最新的进展和研究，尤其是患者在治疗反应和耐受性方面的改善。自从高效抗逆转录病毒疗法（HAART）引入以来，HIV相关淋巴瘤的治疗方案发生了显著变化，HIV阳性患者与免疫功能正常患者的治疗差异变得越来越小。然而，对于重度免疫功能低下患者，仍需要定制化的治疗指南。

 

Oncology Frontier-Hematology Frontier：At this year’s Congress，there was a focus on updating the guidelines for treating HIV-related lymphomas.Could you elaborate on these updates and their significance?

 

Dr.Igor Aurer:About two years ago，we initiated a project to renew the recommendations for treating HIV-related lymphomas.These updated guidelines are crucial as they reflect the latest advancements and research in the field，particularly the improvements in patient responses and tolerability to treatment.Since the introduction of highly active antiretroviral therapy，the approach to treating HIV-related lymphomas has evolved significantly，making the differences in treatment between HIV-positive and immunocompetent individuals smaller.However，specific disease entities unique to severely immunocompromised patients still require tailored guidelines.

 

Dr.Igor Aurer:主要考虑因素之一是用于病毒治疗、感染预防和淋巴瘤治疗的各药物之间的相互作用。在治疗淋巴瘤时，继续使用抗逆转录病毒药物是至关重要的，因为停止使用可能会产生严重后果。此外，需要注意HIV阳性患者中独有的疾病实体，这些在免疫功能正常的个体中并不存在。因此，为了确保有效管理，需要制订特殊的治疗指南。

 

Oncology Frontier-Hematology Frontier：What are the key considerations when treating lymphoma in patients with HIV?

 

Dr.Igor Aurer:One of the primary considerations is the interaction between various drugs used for viral treatment，infectious prophylaxis，and lymphoma treatment.It’s vital to continue antiretroviral medication while treating lymphoma，as stopping it can have severe consequences.Additionally，we need to be mindful of the unique disease entities that occur in HIV-positive patients，which do not appear in immunocompetent individuals.These require special treatment guidelines to ensure effective management.

 

Dr.Igor Aurer：有一个非常有趣的病例，患者是一名新诊断为HIV的患者，同时伴有结核等继发性感染，以及淋巴瘤。该患者严重免疫抑制，同时管理所有这些状况挑战极大。然而，淋巴瘤的治疗和HIV管理却均显示出积极的结果。这个病例强调了拥有综合指南和多学科治疗方法的重要性。

 

Oncology Frontier-Hematology Frontier：At this meeting，clinical cases and panel discussions were also included.Could you please share some cases?

 

Dr.Igor Aurer:We recently treated a patient who was newly diagnosed with HIV，had secondary infections like tuberculosis，and developed lymphoma almost simultaneously.The patient was severely immunosuppressed，and it was a challenge to manage all these conditions concurrently.However，the treatment of lymphoma，alongside HIV management，showed positive outcomes.The case underscored the importance of having comprehensive guidelines and a multidisciplinary approach to treatment.

Dr.Igor Aurer：EHA会议作为血液学领域的国际盛会，为全球专家学者搭建了共享最新科研成果与前沿进展的宝贵平台。展望2025年的EHA盛会，我期待看到在靶向治疗和个性化医学发展方面的持续进步。这些进展无疑将会为患者带来新的希望和更好的治疗。我们期待着下一个激动人心且富有成效的会议。

 

Oncology Frontier-Hematology Frontier：Looking ahead to next year’s EHA meeting in Milan，what are your expectations for the advancements in hematology?

 

Dr.Igor Aurer:The EHA meetings are always a highlight for the hematology community，offering a platform to share the latest research and clinical advancements.Next year in Milan，I expect to see continued progress in the development of targeted therapies and personalized medicine.These advancements will undoubtedly bring new hope and improved treatments for patients.We’re looking forward to another exciting and productive meeting.