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Richard D. Moore, MD, MHSc; Harold Kessler, MD; Douglas D. Richman, MD; Charles Flexner, MD; Richard E. Chaisson, MD

JAMA. 1991;265(17):2208-2211.

Abstract
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.

(JAMA. 1991;265:2208-2211)

Author Affiliations
From the Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Md (Drs Moore, Flexner, and Chaisson); Departments of Medicine and Immunology/Microbiology, Rush-Presbyterian—St Luke's Medical Center, Chicago, Ill (Dr Kessler); and Departments of Pathology and Medicine, University of California—San Diego and San Diego Veterans Affairs Medical Center (Dr Richman).

Footnotes
Reprint requests to Johns Hopkins Hospital, 1830 E Monument St, Room 8059, Baltimore, MD 21205 (Dr Moore).

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