Zhonghua Yu Fang Yi Xue Za Zhi. 2026 Aug 6;60(8):1357-1363. doi: 10.3760/cma.j.cn112150-20260112-00029.
ABSTRACT
This study aims to explore the clinicopathological and immunological characteristics of Talaromyces marneffei (TM) infection in patients with acquired immunodeficiency syndrome-related diffuse large B-cell lymphoma (AIDS-DLBCL), and to analyze the risk factors and prognostic impact. This study was designed as a retrospective cohort study, clinical data of 73 patients with AIDS-DLBCL admitted to the First Hospital of Changsha from January 2020 to December 2021 were collected and analyzed, and the patients aged 26 to 84 years, including 63 males and 10 females.Patients were divided into a TM infection group (n=17) and a non-TM infection group(n=56) based on the presence or absence of TM infection.The clinical and pathological characteristics as well as therapeutic effects of the two groups of patients were compared using the χ2 test and Fisher’s exact test. Survival curves were plotted using the Kaplan-Meier method, and the association between AIDS-DLBCL specific variables and TM infection was analyzed using the binary logistic regression model. The results showed that a total of 73 patients with AIDS-DLBCL were included. Among them, 23.3% had TM infection(17/73). The histopathological examination of biopsy tissues showed that TM appeared as yeast-like round or oval spores under special staining, some of which were sausage-shaped or joint-like, with a septum in the middle, and existed within or outside macrophages. Comparative analysis between the two groups showed that the proportions of patients with HIV-RNA>200 copies/ml [88.24% (15/17) vs. 58.93% (33/56), χ2=4.260, P=0.039], CD4⁺ T cell count<50 cells/μl [41.18% (7/17) vs. 8.93% (5/56), χ2=9.553, P=0.004], occult blood (OB) positivity [47.06% (8/17) vs. 17.86% (10/56), χ²=5.173, P=0.023], and Mycobacterium tuberculosis (MTB) positivity [29.41% (5/17) vs. 3.57% (2/56), Fisher’s exact test, P=0.006] were significantly higher in the TM infection group than in the non-TM infection group, with statistically significant differences between the groups (all P<0.05). Survival curve analysis showed that the 2-year overall survival rate of the TM infection group was significantly lower than that of the non-TM infection group [52.94% (9/17) vs. 92.85% (52/56), χ²=17.670, P<0.001]. The binary logistic regression model analysis showed that CD4+T cell count<50 cells/μl (OR=8.29, 95%CI:1.47-46.81), positive tuberculosis (OR=17.70, 95%CI:2.21-148.01), and positive occult blood (OR=5.19, 95%CI:1.14-23.57) were risk factors affecting the occurrence of TM infection in AIDS-DLBCL. In conclusion, CD4⁺ T cell count<50 cells/μl, occult blood positivity, and tuberculosis positivity may be risk factors for TM infection in patients with AIDS-DLBCL.
PMID:42595546 | DOI:10.3760/cma.j.cn112150-20260112-00029
