Non-Hodgkin's lymphoma in patients with advanced HIV infection treated with zidovudine
R. D. Moore, H. Kessler, D. D. Richman, C. Flexner and R. E. Chaisson
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Md.
We wished to determine the incidence of human immunodeficiency
virus-related high-grade non-Hodgkin's lymphoma (NHL) and identify factors
associated with the development of NHL in patients receiving zidovudine.
Data are from a 2-year prospective, observational, multisite study of 1030
patients with the acquired immunodeficiency syndrome (AIDS) and advanced
AIDS-related complex who received zidovudine. Non-Hodgkin's lymphoma
developed in 24 (2.3%) of 1030 patients who received zidovudine during 1463
person-years of follow-up (rate, 1.6 per 100 person-years of therapy). The
relative hazard for development of NHL was stable throughout 2 years of
therapy, with the risk of developing NHL 0.8% for each additional 6 months
of therapy. Factors associated with development of NHL were a prior
diagnosis of Kaposi's sarcoma, herpes simplex virus infection, or lower
mean neutrophil count. Less strongly associated was a prior diagnosis of
oral hairy leukoplakia or homosexual transmission of HIV. By Cox
proportional hazards analysis, a prior diagnosis of Kaposi's sarcoma,
cytomegalovirus disease, or oral hairy leukoplakia was most strongly
associated with development of NHL. Our study demonstrates a relatively
high incidence of NHL in patients with advanced human immunodeficiency
virus disease who are undergoing antiretroviral therapy and suggests
possible risk factors for development of NHL.
