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Purpose The incidence and mortality of secondary malignant tumors (MT) in people living with HIV(PLWH) are increasing. The purpose of this study is to analyze the characteristics of Complete Blood Count (CBC), bone marrow and immunity in PLWH with secondary MT, so as to provide data reference for diagnosis and risk factor assessment strategies of such patients.Methods We collected 297 patients who were diagnosed with PLWH and required bone marrow examination, including 101 cases of PLWH with secondary MT and 196 cases of PLWH without MT. The CBC, bone marrow and immune index of the two groups of patients were retrospectively analyzed.Results In terms of WBC, RBC, HGB, PLT, NEUT, the granulocyte ratio in bone marrow and CD4 cell counts, both were lower than those of pure PLWH. The independent risk factors of PLWH with secondary MT were HGB < 90g/L (RR = 1.581, 95%CI: 1.030–2.427, P = 0.036), the morphology of RBC in BM showed senescent nuclei and immature cytoplasm (RR = 1.489, 95%CI: 1.006–2.203, P = 0.046) and CD4 cell count < 100 cells/ul (RR = 2.307, 95%CI: 1.406–3.787, P = 0.001). HGB < 60g/L and RBC ratio of bone marrow < 0.2 were the independent risk factors associated with prognosis. The best hematologic predictor of PLWH with secondary MT was HGB (AUC = 0.707, 95%CI: 0.642–0.772, P < 0.001).Conclusion Severe anemia, the abnormal morphology of RBC in bone marrow, severe immune deficiency increase the risk of secondary MT in PLWH. Severe anemia and decreased RBC ratio in bone marrow are independent factors affecting the prognosis of PLWH with secondary MT.

Background: Thrombocytopenia is a common hematological manifestation in people living with human immunodeficiency virus (HIV) or acquired immune deficiency syndrome (AIDS; PLWHA). Data on the prognostic relationship and associated factors of thrombocytopenia and HIV infection in China are limited. Objectives: We assessed the prevalence of thrombocytopenia, its association with prognosis, and analyzed the associated risk factors among demographic characteristics, comorbidities, hematological and bone marrow indicators. Design: We collected patients identified as PLWHA in Zhongnan Hospital. The patients were divided into two groups: the thrombocytopenia group and the non-thrombocytopenia group. We analyzed and compared demographic characteristics, comorbidities, peripheral blood cells, lymphocyte subpopulations, infection indicators, bone marrow cytology, and bone marrow morphology of the two groups. Then we analyzed the risk factors for thrombocytopenia and the effect of platelet (PLT) values on the prognosis of patients. Methods: Demographic characteristics and laboratory results were obtained from medical records. In contrast to other studies, we included bone marrow cytology and morphology in this study. Data were analyzed with multivariate logistic regression analysis. The Kaplan–Meier method was used to plot 60-month survival curves for the severe, mild, and non-thrombocytopenia groups. The value p < 0.05 was taken as statistically significant. Results: Among 618 identified PLWHA, 510 (82.5%) were male. Overall, thrombocytopenia was found in 37.7% [95% confidence interval (CI): 33.9–41.5%]. Multivariable logistic regression analysis showed that age ⩾40 years [adjusted odds ratio (AOR) 1.869, 95% CI: 1.052–3.320], combined with hepatitis B (AOR 2.004, 95% CI: 1.049–3.826), high procalcitonin (PCT) count (AOR 1.038, 95% CI: 1.000–1.078) were risk factors of thrombocytopenia in PLWHA. An increased percentage of thrombocytogenic megakaryocytes was a protective factor, with an AOR 0.949 (95% CI: 0.930–0.967). Kaplan–Meier survival curve analysis showed that the prognosis was worse in the severe than in the mild ( p = 0.002) and non-thrombocytopenia groups ( p = 0.008). Conclusion: We discovered a general high pervasiveness of thrombocytopenia in PLWHA in China. Age ⩾40 years, combined with hepatitis B virus infection, high PCT, and decreased percentage of thrombocytogenic megakaryocytes indicated a higher risk for developing thrombocytopenia. A PLT count ⩽50 × 109/liter led to a worse prognosis. Therefore, early diagnosis and treatment of thrombocytopenia in these patients are useful.