The full content of Annals is available to subscribers

Subscribe/Learn More  >
Original Research |

Development of Non-Hodgkin Lymphoma in a Cohort of Patients with Severe Human Immunodeficiency Virus (HIV) Infection on Long-Term Antiretroviral Therapy

James M. Pluda, MD; Robert Yarchoan, MD; Elaine S. Jaffe, MD; Irwin M. Feuerstein, MD; Diane Solomon, MD; Seth M. Steinberg, PhD; Kathleen M. Wyvill, RN; Andrew Raubitschek, MD; David Katz, MD; and Samuel Broder, MD
[+] Article, Author, and Disclosure Information

Requests for Reprints: James M. Pluda, MD, National Institutes of Health, Building 10, Room 13N248 Bethesda, MD 20892.

Current Author Addresses: Drs. Pluda and Yarchoan: National Institutes of Health, Building 10, Room 13N248, Bethesda, MD 20892.

Dr. Jaffe: National Institutes of Health, Building 10, Room 2N202, Bethesda, MD 20892.

Dr. Feuerstein: National Institutes of Health, Building 10, Room 1C660, Bethesda, MD 20892.

Dr. Solomon: National Institutes of Health, Building 10, Room 2A19, Bethesda, MD 20892.

Dr. Steinberg: National Institutes of Health, Building 10, Room 13C 103, Bethesda, MD 20892.

Ms. Wyvill: National Institutes of Health, Building 10, Room 12N226, Bethesda, MD 20892.

Dr. Raubitschek: National Institutes of Health, Building 10, Room B3B69, Bethesda, MD 20892.

Dr. Katz: National Institutes of Health, Building 10, Room 2N212, Bethesda, MD 20892.

Dr. Broder: National Institutes of Health, Building 31, Room 11A48, Bethesda, MD 20892.

Ann Intern Med. 1990;113(4):276-282. doi:10.7326/0003-4819-113-4-276
Text Size: A A A

Objective: To describe the incidence of non-Hodgkin lymphoma in a group of patients with symptomatic human immunodeficiency virus (HIV) infection receiving long-term dideoxynucleoside antiretroviral therapy.

Design: We examined the records of all patients with the acquired immunodeficiency syndrome (AIDS) or severe AIDS-related complex who were entered into three long-term phase I trials of zidovudine (azidothymidine, AZT) or zidovudine-containing regimens at the National Cancer Institute between 1985 and 1987.

Setting: The Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland.

Participants: Fifty-five HIV-infected patients with AIDS or severe AIDS-related complex.

Measurements and Main Results: Eight of fifty-five patients (14.5%; 95% CI, 6.5% to 26.7%) developed a high-grade non-Hodgkin lymphoma of B-cell type, a median of 23.8 months (range, 13 to 35 months) after starting antiretroviral treatment. Using the method of Kaplan and Meier, the estimated probability of developing lymphoma by 30 months of therapy was 28.6% (CI, 13.7% to 50.3%) and by 36 months, 46.4% (CI, 19.6% to 75.5%). The patients who developed lymphoma had less than 100 T4 cells/mm3 for a median of 17.8 months (range, 7 to 35 months) and less than 50 T4 cells/mm3 for a median of 15.3 months (range, 5.5 to 35 months) before the diagnosis. All patients presented with non-Hodgkin lymphoma in extranodal sites, and two developed primary brain involvement in the setting of Toxoplasma infection.

Conclusion: Patients with symptomatic HIV infection who survive for up to 3 years on antiretroviral therapy may have a relatively high probability of developing non-Hodgkin lymphoma. Prolonged survival in the setting of profound immunosuppression with substantial T4-cell depletion is probably an important factor in the development of these lymphomas. However, a direct role of therapy itself cannot be totally discounted. As improved therapies for the treatment of HIV infection and its complications result in prolonged survival, non-Hodgkin lymphoma may become an increasingly significant problem.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $42.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.