Incidence of lymphomas and other cancers in HIV-infected and HIV-uninfected patients with hemophilia
C. S. Rabkin, M. W. Hilgartner, K. W. Hedberg, L. M. Aledort, A. Hatzakis, S. Eichinger, M. E. Eyster, G. C. White 2nd, C. M. Kessler, M. M. Lederman and al. et
Viral Epidemiology Section, National Cancer Institute, Rockville, MD 20852.
OBJECTIVE--To determine the types and rates of cancers occurring in excess
in the presence of infection with the human immunodeficiency virus type 1
(HIV-1). DESIGN--Cohort analytic study of HIV-infected and HIV-uninfected
subjects followed for up to 12 years. SETTING--Fifteen hemophilia treatment
centers. PATIENTS--A total of 1701 patients with hemophilia, of whom 1065
(63%) were HIV-1 seropositive. MAIN OUTCOME MEASURES--Morphologic
classification and incidence rates of cancers. MAIN RESULTS--The incidence
of non-Hodgkin's lymphoma after HIV seroconversion averaged 0.15 case per
100 person-years (95% confidence interval [CI], 0.08 to 0.25) and rose
exponentially with increasing duration of HIV infection. Although the
greatest absolute risk of lymphoma was in the oldest age group, the
relative increase compared with general population rates was 38-fold in
subjects 10 to 39 years old and 12-fold in older subjects (P less than
.05). The CD4+ T-lymphocyte levels for lymphoma cases were similar to
HIV-positive subjects without the acquired immunodeficiency syndrome (AIDS)
who had been infected for the same length of time. The incidence of
Kaposi's sarcoma was increased 200-fold (95% CI, 20 to 700). The incidence
of cancers other than non-Hodgkin's lymphoma and Kaposi's sarcoma were not
increased in the HIV-positive subjects (ratio of observed to expected
cases, 0.9 [95% CI, 0.4 to 1.9]). The HIV-negative subjects had no
significant increase in cancer incidence. CONCLUSIONS--HIV infection has
restricted effects on cancer incidence that are only partly explained by
immunosuppression. Paradoxically, improvements in therapy of HIV infection
that prolong survival may lead to further increases in HIV-associated
lymphoma.
Risk Factors for Pediatric Human Immunodeficiency Virus-Related Malignancy
Pollock et al.
JAMA 2003;289:2393-2399.
ABSTRACT
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Ham-Wasserman Lecture : Hemophilia and Related Bleeding Disorders: A Story of Dismay and Success
Mannucci
ASH Education Book 2002;2002:1-9.
ABSTRACT
| FULL TEXT
The Hemophilias -- From Royal Genes to Gene Therapy
Mannucci and Tuddenham
NEJM 2001;344:1773-1779.
FULL TEXT
Highly Active Antiretroviral Therapy and Incidence of Cancer in Human Immunodeficiency Virus-Infected Adults
International Collaboration on HIV and Cancer
JNCI J Natl Cancer Inst 2000;92:1823-1830.
ABSTRACT
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Epstein-Barr Virus Infection Is Predictive of CNS Involvement in Systemic AIDS-Related Non-Hodgkin's Lymphomas
Cingolani et al.
JCO 2000;18:3325-3330.
ABSTRACT
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Chemokine and Chemokine Receptor Gene Variants and Risk of Non-Hodgkin's Lymphoma in Human Immunodeficiency Virus-1-Infected Individuals
Rabkin et al.
Blood 1999;93:1838-1842.
ABSTRACT
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Association of Non-Acquired Immunodeficiency Syndrome-Defining Cancers With Human Immunodeficiency Virus Infection
Rabkin
J Natl Cancer Inst Monogr 1998;1998:23-25.
ABSTRACT
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Hodgkin's Disease in the Setting of Human Immunodeficiency Virus Infection
Levine
J Natl Cancer Inst Monogr 1998;1998:37-42.
ABSTRACT
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