AIDS-associated non-Hodgkin's lymphomas as primary and secondary AIDS diagnoses in hemophiliacs. Hemophilia Malignancy Study Group.
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.
Ragni
M V
MV
University of Pittsburgh School of Medicine, Hemophilia Center of Western Pennsylvania 15213, USA.
Belle
S H
SH
Jaffe
R
R
Locker
J
J
Duerstein
S L
SL
Bass
D C
DC
Addiego
J E
JE
Aledort
L M
LM
Barron
L E
LE
Brettler
D B
DB
Buchanan
G R
GR
Gill
J C
JC
Ewenstein
B M
BM
Green
D
D
Hilgartner
M W
MW
Hoots
W K
WK
Kisker
C T
CT
Lovrien
E W
EW
Rutherford
C J
CJ
Sanders
N L
NL
Smith
K J
KJ
Stabler
S P
SP
Swindells
S
S
White
G C
GC
Kingsley
L A
LA
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