HIV-associated extranodal NK/T cell lymphoma, nasal type: a case report and literature review
- 1Center of Infectious Diseases, West China Hospital of Sichuan University
- 2Department of Hematology, West China Hospital of Sichuan University
- 3Department of Histology, West China Hospital of Sichuan University
Abstract
Extranodal NK/T-cell lymphoma (ENKTCL) is a rare aggressive lymphoma whose management is complicated by HIV-1 co-infection due to drug-drug interactions and overlapping toxicities, specifically the convergent hepatorenal and hematological toxicities resulting from the concurrent use of chemotherapeutic regimens and ART. We report a middle-aged HIV-1 positive man (CD4 ⁺ T cells:198/μL, HIV-1 RNA:9.70×10³ copies/mL) with stage IE ENKTCL nasal type, whose initial nasal congestion was repeatedly misdiagnosed as sinusitis. An integrase strand transfer inhibitor-based (INSTIs) ART was unaffordable, and efavirenz was contraindicated by prior allergy, necessitating continuation of lopinavir/ritonavir-based ART despite its CYP3A4 inhibition. A multidisciplinary team guided concurrent therapy with two full-dose cycles of P-GemOxD (gemcitabine, pegaspargase, oxaliplatin, dexamethasone) followed by consolidative radiotherapy (20 fractions). The patient tolerated treatment without grade ≥ 3 adverse events. Post-therapy PET-CT confirmed complete metabolic response, with HIV-1 RNA undetectable. At 9-month follow-up, remission persisted and CD4 ⁺ T cells rose to 255/μL. This case illustrates that an MDT model offers a practical management framework for delivering full-dose P-GemOxD chemotherapy with non-INSTIs when INSTI-based regimens are not accessible. Our experience provides a reference strategy for managing the therapeutic complexities of concurrent HIV and malignancy.
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BibTeX
@article{wang2026hivassociated,
title = {{HIV-associated extranodal NK/T cell lymphoma, nasal type: a case report and literature review}},
author = {Junjie Wang and Lingyao Du and Tian Dong and Sha Zhao and Jie Ji and Hong Tang},
journal = {Frontiers in Immunology},
year = {2026},
month = oct,
doi = {10.3389/fimmu.2026.1954471},
url = {https://www.frontiersin.org/articles/10.3389/fimmu.2026.1954471/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - HIV-associated extranodal NK/T cell lymphoma, nasal type: a case report and literature review
AU - Junjie Wang
AU - Lingyao Du
AU - Tian Dong
AU - Sha Zhao
AU - Jie Ji
AU - Hong Tang
PY - 2026
DA - 2026/10/07
JO - Frontiers in Immunology
DO - 10.3389/fimmu.2026.1954471
UR - https://www.frontiersin.org/articles/10.3389/fimmu.2026.1954471/full
AB - Extranodal NK/T-cell lymphoma (ENKTCL) is a rare aggressive lymphoma whose management is complicated by HIV-1 co-infection due to drug-drug interactions and overlapping toxicities, specifically the convergent hepatorenal and hematological toxicities resulting from the concurrent use of chemotherapeutic regimens and ART. We report a middle-aged HIV-1 positive man (CD4 ⁺ T cells:198/μL, HIV-1 RNA:9.70×10³ copies/mL) with stage IE ENKTCL nasal type, whose initial nasal congestion was repeatedly misdiagnosed as sinusitis. An integrase strand transfer inhibitor-based (INSTIs) ART was unaffordable, and efavirenz was contraindicated by prior allergy, necessitating continuation of lopinavir/ritonavir-based ART despite its CYP3A4 inhibition. A multidisciplinary team guided concurrent therapy with two full-dose cycles of P-GemOxD (gemcitabine, pegaspargase, oxaliplatin, dexamethasone) followed by consolidative radiotherapy (20 fractions). The patient tolerated treatment without grade ≥ 3 adverse events. Post-therapy PET-CT confirmed complete metabolic response, with HIV-1 RNA undetectable. At 9-month follow-up, remission persisted and CD4 ⁺ T cells rose to 255/μL. This case illustrates that an MDT model offers a practical management framework for delivering full-dose P-GemOxD chemotherapy with non-INSTIs when INSTI-based regimens are not accessible. Our experience provides a reference strategy for managing the therapeutic complexities of concurrent HIV and malignancy.
SN - 1664-3224
ER -