title: AIDS-related Burkitt lymphoma in the United States: what do age and CD4 lymphocyte patterns tell us about etiology and/or biology?
abstract: Trimodal or bimodal age-specific incidence rates for Burkitt lymphoma (BL) were observed in the United States general population, but the role of immunosuppression could not be excluded. Incidence rates, rate ratios, and 95% confidence intervals for BL and other non-Hodgkin lymphoma (NHL), by age and CD4 lymphocyte count categories, were estimated using Poisson regression models using data from the United States HIV/AIDS Cancer Match study (1980-2005). BL incidence was 22 cases per 100 000 person-years and 586 for non-BL NHL. Adjusted BL incidence rate ratio among males was 1.6× that among females and among non-Hispanic blacks, 0.4× that among non-Hispanic whites, but unrelated to HIV-transmission category. Non-BL NHL incidence increased from childhood to adulthood; in contrast, 2 age-specific incidence peaks during the pediatric and adult/geriatric years were observed for BL. Non-BL NHL incidence rose steadily with decreasing CD4 lymphocyte counts; in contrast, BL incidence was lowest among people with ≤ 50 CD4 lymphocytes/μL versus those with ≥ 250 CD4 lymphocytes/μL (incidence rate ratio 0.3 [95% confidence interval = 0.2-0.6]). The bimodal peaks for BL, in contrast to non-BL NHL, suggest effects of noncumulative risk factors at different ages. Underascertainment or biological reasons may account for BL deficit at low CD4 lymphocyte counts.
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA. guechome@mail.nih.gov
authors.forename: Mercy
authors.initials: M
authors.lastname: Guech-Ongey
authors.forename: Edgar P
authors.initials: EP
authors.lastname: Simard
authors.forename: William F
authors.initials: WF
authors.lastname: Anderson
authors.forename: Eric A
authors.initials: EA
authors.lastname: Engels
authors.forename: Kishor
authors.initials: K
authors.lastname: Bhatia
authors.forename: Susan S
authors.initials: SS
authors.lastname: Devesa
authors.forename: Sam M
authors.initials: SM
authors.lastname: Mbulaiteye
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002051:Burkitt Lymphoma / Q000453:epidemiology* / Q000276:immunology* / Q000473:pathology; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D016483:Lymphoma, AIDS-Related / Q000453:epidemiology* / Q000276:immunology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D014481:United States / Q000453:epidemiology; D055815:Young Adult
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