THE DEVELOPMENT OF OPPORTUNISTIC NON-HODGKIN'S LYMPHOMA (NHL) IN PATIENTS (PTS) RECEIVING LONG-TERM ANTIRETROVIRAL THERAPY (MEETING ABSTRACT) NLM AIDSLINE Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.

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THE DEVELOPMENT OF OPPORTUNISTIC NON-HODGKIN'S LYMPHOMA (NHL) IN PATIENTS (PTS) RECEIVING LONG-TERM ANTIRETROVIRAL THERAPY (MEETING ABSTRACT)

Proc Annu Meet Am Soc Clin Oncol; 11:A5 1992. Unique Identifier : AIDSLINE ICDB/92680736
Pluda JM; Venzon D; Tosato G; Lietzau J; Wyvill K; Nelson D; Karp J; Broder S; Yarchoan R; NCI, Bethesda, MD

Abstract: We have previously reported the development of NHL in 8 of 55 pts receiving long-term AZT-based antiretroviral therapy at the NCI (Pluda et al, Ann Intern Med 113:276, 1990). None of the 7 pts remaining alive in that cohort has since developed NHL, and the current estimated probabilities of pts with AIDS or severe HIV infection developing a NHL are 12% (95% CI 5-27%) after 24 mo of AZT-based therapy and 29% (95% CI 14-49%) after 36 mo. Analysis of this cohort revealed that entry CD4 and CD8 counts, serum HIV p24 Ag, serum IgG and IgA, Epstein-Barr virus titers, and serum IL-2 receptor levels did not predict for the subsequent development of NHL. However, pts with elevated serum IL-6 levels at entry had a higher probability of developing NHL over 3 yr than pts with lower entry IL-6 levels (P2 less than 0.05). Serum IL-6 levels tended to increase over time, although the magnitude of the increase was not correlated with an altered risk of developing NHL. The potential role of IL-6 in the development of NHL bears further investigation. We are also following a separate cohort of 61 pts receiving ddI. These pts were comparable at entry to the AZT cohort. Four developed NHL, with an estimated probability of 6% (95% CI 2-17%) after 2 yr of ddI (P2=0.13 for a difference from the AZT-based cohort). Evaluating all 116 AZT and ddI pts together, the estimated probability of NHL after 2 yr of therapy is 8% (95% CI 4-17%), increasing to 19% (95% CI 11-32%) after 3 yr. In this combined cohort, NHL was significantly more likely to occur in pts whose CD4 count had fallen below 50 cells/mm3 (P2=0.008). Thus, prolonged survival of pts on antiretroviral therapy is associated with a risk of their developing NHL. This risk becomes significantly greater if the CD4 count falls below 50 cells/mm3.
Keywords: Acquired Immunodeficiency Syndrome/*COMPLICATIONS/*DRUG THERAPY/ IMMUNOLOGY Antigens, CD4/ANALYSIS Antigens, CD8/ANALYSIS Biological Markers/BLOOD Didanosine/*ADVERSE EFFECTS/THERAPEUTIC USE Follow-Up Studies Human HIV Infections/*COMPLICATIONS/*DRUG THERAPY/IMMUNOLOGY IgA/ANALYSIS IgG/ANALYSIS Interleukin-6/BLOOD Lymphoma, Non-Hodgkin's/CHEMICALLY INDUCED/*ETIOLOGY Probability Prognosis Time Factors Zidovudine/*ADVERSE EFFECTS/THERAPEUTIC USE ABSTRACT

KWDacquiredimmunodeficiencysyndrome/KWDcomplications/KWDdrugtherapy/immunologyantigens,cd4/analysisantigens,cd8/analysisbiologicalmarkers/blooddidanosine/KWDadverseeffects/therapeuticusefollow-upstudieshumanhivinfections/KWDcomplications/KWDdrugtherapy/immunologyiga/analysisigg/analysisinterleukin-6/bloodlymphoma,non-hodgkin's/chemicallyinduced/KWDetiologyprobabilityprognosistimefactorszidovudine/KWDadverseeffects/therapeuticuseabstract
921130
M92B0903

Copyright © 1992 - National Library of Medicine. Reproduced under license with the National Library of Medicine, Bethesda, MD.

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