Non-Hodgkin's Lymphoma in Patients With Advanced HIV Infection Treated With Zidovudine

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.

Risk Factors for Kaposi's Sarcoma in Patients With Advanced Human Immunodeficiency Virus Disease Treated With Zidovudine

“…The probability of de¬ veloping KS in 2 years in patients with an enrollment di¬ agnosis ofAIDS was 25.2% (95% CI, 20.2% to 30.3%), com¬ pared with 17.5% (95% CI, 13.4%to 21.5%) for those with an enrollment diagnosis ofAIDS-related complex (P< .05, Figure 1 ). The probability of developing KS in 2 years in patients with a baseline CD4 cell count of less than 0.1X107L was 24.9% (95% CI, 19.3% to 30.4%), com¬ pared with 15.1% (95% CI, 11.0% to 19.3%) for those with a CD4 cell count of0.1X109/L or more (P< .01, Figure 2). …”

Report of a Case of Primary Skeletal Muscle Lymphoma and Review of the Literature

“…None of the reported cases has a preceding history of myo sitis or thigh injuries. On the other hand, the incidence of extranodal involvement in HIV-associated non-Hodg kin's lymphoma is known to be as high as 45-58%, even after excluding lymphoma of the central nervous system [21][22][23], Primary skeletal muscle lymphoma has also been described in these patients [24,25]. We do not know the mechanism by which a state of immunodeficiency results in a predilection of extranodal involvement in non-Hodg kin's lymphoma.…”

Human Immunodeficiency Virus and Oral Health

“…Oral NHL may appear as solitary lesions with no evidence of disseminated disease. 29,30 Ulcerations or masses those are painful, firm, elastic, often reddish or purplish. They enlarge rapidly with the most common areas involved being the gums of the back teeth, the roof of the mouth (soft palate), back molar area, tonsils areas and tongue.…”