title: AIDS-associated non-Hodgkin's lymphomas as primary and secondary AIDS diagnoses in hemophiliacs. Hemophilia Malignancy Study Group.
abstract: We studied the characteristics and temporal trends of AIDS- associated non-Hodgkin's lymphoma (AIDS-NHL) in individuals with hemophilia. Prospective data were collected on 33 HIV-positive hemophiliacs with AIDS-NHL enrolled in the Hemophilia Malignancy Study (HMS), of whom 21 had primary and 12 had secondary or subsequent AIDS-defining illnesses, and analyzed for frequency and temporal trends. As compared with primary AIDS- NHL, secondary AIDS-NHL occurred at an older mean age, 37 versus 29 years (p = 0.12); at a lower mean CD4 count, 46 versus 154 (p = 0.07); after a longer period of immunosuppression (CD4 < 200/microl), 41 versus 16 months (p = 0.03); and with shorter median survival, 2 versus 7 months (p = 0.09). The presence of EBV in tumor tissue was associated with shorter survival, 1 versus 7 months (p = 0.17). Between 1981 and 1988 and 1989 and 1994, the proportion of primary AIDS diagnoses that were AIDS-NHL changed minimally, 4.6 versus 6.1%, whereas there were significant decreases in Pneumocystis carinii pneumonia (PCP, p = 0.02) and wasting (p = 0.07), and an increase in Candida (p = 0.004). These findings confirm that an increasing proportion of AIDS-NHL in hemophiliacs are occurring as secondary or later AIDS diagnoses, and they are associated with prolonged duration of immunosuppression.
authors.affiliation: University of Pittsburgh School of Medicine, Hemophilia Center of Western Pennsylvania 15213, USA.
authors.forename: M V
authors.initials: MV
authors.lastname: Ragni
authors.forename: S H
authors.initials: SH
authors.lastname: Belle
authors.forename: R
authors.initials: R
authors.lastname: Jaffe
authors.forename: J
authors.initials: J
authors.lastname: Locker
authors.forename: S L
authors.initials: SL
authors.lastname: Duerstein
authors.forename: D C
authors.initials: DC
authors.lastname: Bass
authors.forename: J E
authors.initials: JE
authors.lastname: Addiego
authors.forename: L M
authors.initials: LM
authors.lastname: Aledort
authors.forename: L E
authors.initials: LE
authors.lastname: Barron
authors.forename: D B
authors.initials: DB
authors.lastname: Brettler
authors.forename: G R
authors.initials: GR
authors.lastname: Buchanan
authors.forename: J C
authors.initials: JC
authors.lastname: Gill
authors.forename: B M
authors.initials: BM
authors.lastname: Ewenstein
authors.forename: D
authors.initials: D
authors.lastname: Green
authors.forename: M W
authors.initials: MW
authors.lastname: Hilgartner
authors.forename: W K
authors.initials: WK
authors.lastname: Hoots
authors.forename: C T
authors.initials: CT
authors.lastname: Kisker
authors.forename: E W
authors.initials: EW
authors.lastname: Lovrien
authors.forename: C J
authors.initials: CJ
authors.lastname: Rutherford
authors.forename: N L
authors.initials: NL
authors.lastname: Sanders
authors.forename: K J
authors.initials: KJ
authors.lastname: Smith
authors.forename: S P
authors.initials: SP
authors.lastname: Stabler
authors.forename: S
authors.initials: S
authors.lastname: Swindells
authors.forename: G C
authors.initials: GC
authors.lastname: White
authors.forename: L A
authors.initials: LA
authors.lastname: Kingsley
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000175:diagnosis; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000175:diagnosis*; D000328:Adult; D006467:Hemophilia A / Q000150:complications* / Q000821:virology; D006801:Humans; D016483:Lymphoma, AIDS-Related / Q000150:complications* / Q000175:diagnosis*; D008228:Lymphoma, Non-Hodgkin / Q000150:complications* / Q000175:diagnosis*; D009369:Neoplasms / Q000150:complications / Q000175:diagnosis; D011446:Prospective Studies