A 27-year-old male with HIV-associated naïve and high-risk Burkitt’s lymphoma sequentially received short-term, high-dose non-myeloablative chemotherapy and autologous CD34-positive stem cell transfusion in the setting of combined antiretroviral therapy (cART). Prompt hematopoietic recovery was observed after 2 weeks and clinical remission from Burkitt’s lymphoma within approximately 30 months after transplantation. The HIV RNA load was inhibited persistently, and drug resistance was not observed. The CD4+ T cell count approached 323 cells/μL in a recent follow-up study. This case suggests that the use of intensive non-myeloablative chemotherapy with transplantation, combined with antiretroviral therapy, in HIV-related naive and high-risk Burkitt’s lymphoma was tolerated and safe.

Acquired Immunodeficiency Syndrome (AIDS)-related lymphoma has diverse clinical manifestations, and its diagnosis is often challenging. Misdiagnosis can delay treatment and affect patient prognosis. We assessed the clinical data of eight patients with atypical clinical manifestations of AIDS-related lymphoma, to enhance physicians' understanding of these patients, and reduce the potential for misdiagnosis. A retrospective analysis was conducted on eight patients with atypical manifestations of AIDS-related lymphoma admitted to the Department of Infectious Diseases of Yunnan Provincial Hospital between May 2017 and May 2023. They were initially misdiagnosed with opportunistic infections, and were later diagnosed with lymphoma. The patients comprised five males and three females. Cluster of Differentiation 4 (CD₄) counts were lower than 200/μl for all patients, and inflammatory marker levels were elevated to varying degrees. Four patients had recurrent fever, one had bleeding, one had pulmonary infection, one had long-term diarrhoea, and one had visual impairment as the primary symptoms. Six patients were diagnosed through bone marrow cytology and biopsy, one through colonoscopy and pathological biopsy, and one through computed tomography-guided percutaneous lung biopsy. All patients had extranodal involvement, including one case in the intestine, one in the lung, and six in the bone marrow. All patients were at lymphoma stage IV, with four in Group A and four in group B. In patients with AIDS, particularly those with low CD4 counts and unexplained fever, atypical lymphoma should be considered, and tissue biopsy should be performed to further confirm the diagnosis.

Objective: To investigate the short-term efficacy and safety of different chemotherapy regimens combined with thalidomide, in the treatment of low-income patients with newly diagnosed HIV -associated diffuse large B -cell lymphoma . Methods: A retrospective analysis was performed on 42 patients with HIV-DLBCL who were admitted to the Infectious Diseases Department of Yunnan Provincial Infectious Diseases Hospital from January 2018 to December 2020. 14 cases (including 1 case in stage II and 13 cases in stage III/IV) were treated with R -CHOP, 24 cases (including 1 case in stage II and 23 cases in stage III/IV) were treated with R-DAEPOCH, and 4 cases (including 1 case in stage II and 3 cases in stage III/IV) were treated with EPOCH. All patients were treated with thalidomide. The ART regimen was adjusted. At least 1 and up to 6 intrathecal injections were given during chemotherapy, and cotrimoxazole was taken orally to prevent infection. The clinical efficacy was evaluated after 4 cycles of chemotherapy, and adverse events were evaluated at each cycle of chemotherapy. Results: All patients received 1 -8 cycles of chemotherapy. CR (64.2 %) was achieved in 9 patients in R -CHOP group, and 5 patients died. In the R-DAEPOCH group, 17 patients achieved CR (70.8 %) and 7 died. In the EPOCH group, 2 patients reached CR (50 %) and 2 died. The main adverse reactions were grade II and above myelosuppression. Conclusion: Combined treatment with thalidomide can improve the prognosis of low-income patients with newly diagnosed HIV-DLBCL.

Diffuse large B-cell lymphoma (DLBCL) is a highly aggressive B-lymphocyte-derived malignant proliferative disease that is currently one of the leading causes of death in HIV patients. The incidence of lymphoma in HIV patients is 60–200 times higher than in the general population compared to the non-HIV population, and diffuse large B-cell lymphoma can cause numerous disease manifestations, especially in severely immunocompromised individuals. We treated a case of HIV-associated splenic diffuse large B-cell lymphoma combined with hepatitis C and tuberculous meningitis. In this case, diffuse large B-cell lymphoma of the spleen was difficult to diagnose. Second, simultaneous treatment of multiple diseases requires consideration of drug interactions. Our case highlights the diagnostic value of early tissue biopsy and the importance of avoiding drug interactions during treatment, and the selection of appropriate CART, anti-hepatitis C, and anti-tuberculosis protocols to reduce mortality from diffuse large B-cell lymphoma comorbidification.