title: Non-AIDS-defining hematological malignancies in HIV-infected patients:  an epidemiological study in Japan.
abstract: OBJECTIVE
  To clarify the incidence and clinical outcomes of non-AIDS-defining hematological malignancies (NADHMs), excluding non-Hodgkin's lymphomas, in HIV-infected patients.
  
  
  METHODS
  A nationwide epidemiological study was conducted to evaluate the incidence and clinical outcomes of NADHMs.
  
  
  METHODS
  Questionnaires were sent to 429 regional AIDS centers and 497 educational hospitals certified by the Japanese Society of Hematology. Data from 511 institutes were obtained.
  
  
  RESULTS
  From 1991 to 2010, 47 patients with NADHMs were detected (median age, 42.0 years; male, 93.6%). The median CD4-positive T-cell count was 255/μl, and the median duration from the diagnosis of HIV infection to development of hematological malignancy was 28.0 months. Most patients with acute leukemia were treated with standard induction chemotherapy. Complete remission rates and median overall survival periods for acute myeloblastic leukemia (AML) and acute lymphoblastic leukemia (ALL) were 70.0 and 85.7% and 13 and 16 months, respectively. Three of four patients with chronic-phase chronic myeloid leukemia (CML-CP) were well controlled with imatinib. Five patients (2 AML, 1 ALL, 1 accelerated-phase CML, and 1 myeloma) were treated with autologous or allogeneic stem-cell transplantation. Comparison of patients over the two periods (1991-2000 and 2001-2009) revealed a 4.5-fold increase in the incidence of hematological malignancies.
  
  
  CONCLUSIONS
  The incidence of NADHMs has increased in the past decade. The prognosis of these patients was similar to that of HIV-negative patients; therefore, standard chemotherapy may be a feasible treatment option for HIV-infected patients with hematological malignancies.
authors.affiliation: Division of Hematology, Department of Internal medicine, National Medical Center for Global Health and Medicine, Tokyo 162–8655, Japan. shagiwar@hosp.ncgm.go.jp
authors.forename: Shotaro
authors.initials: S
authors.lastname: Hagiwara
authors.forename: Mihoko
authors.initials: M
authors.lastname: Yotsumoto
authors.forename: Takashi
authors.initials: T
authors.lastname: Odawara
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ajisawa
authors.forename: Tomoko
authors.initials: T
authors.lastname: Uehira
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Nagai
authors.forename: Junko
authors.initials: J
authors.lastname: Tanuma
authors.forename: Seiji
authors.initials: S
authors.lastname: Okada
mesh_terms: D000328:Adult; D000368:Aged; D018791:CD4 Lymphocyte Count; D016021:Epidemiologic Studies; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology*; D019337:Hematologic Neoplasms / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D007938:Leukemia / Q000150:complications / Q000453:epidemiology*; D008223:Lymphoma / Q000150:complications / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D055815:Young Adult