We describe the anatomic and histologic presentation and prognosis of non-Hodgkin's lymphoma (NHL) among people with AIDS (PWA) and determine their contribution to the NHL burden.
We linked AIDS and cancer registries in selected areas of the United States and compared NHL sites and histologies in PWA and non-PWA, after adjusting for age, sex and ethnicity.
Among 51,033 PWA, we found 2,156 cases of NHL (4.3%). Half of NHL cases occurring post-AIDS were not reported to AIDS registries.
NHL was part of an AIDS-defining condition for 3.2% of all PWA ; the relative risk of NHL with 3.5 years of another AIDS diagnosis was 165-fold compared to non-PWA within the cancer surveillance system.
Of NHLs, 39% were high grade (vs. 12% among non-PWA), 60% were nodal (vs. 74% among non-PWA) and 15% had brain primaries (vs. 1% among non-PWA).
Excluding brain sites, extranodal sites were still 20% more common than expected.
Relative risk was elevated for all histologic types, with the risk ranging from 652-fold for high-grade diffuse immunoblastic tumors and 261-fold for Burkitt's lymphomas to 113 for intermediate-grade lymphoma to 14-fold for low-grade lymphoma.
Survival among PWA with NHL was poor, and tumor grade had little impact.
In high-risk AIDS areas, AIDS-related NHLs constitute a major share of the NHL burden.
We conclude that NHL risk is considerably under-estimated in AIDS registry data. (...)
Mots-clés Pascal : SIDA, Virose, Infection, Facteur risque, Complication, Lymphome non hodgkinien, Incidence, Grade histologique, Type histologique, Localisation, Epidémiologie, Registre, Etats Unis, Amérique du Nord, Amérique, Pronostic, Homme, Immunopathologie, Immunodéficit, Hémopathie maligne, Lymphoprolifératif syndrome
Mots-clés Pascal anglais : AIDS, Viral disease, Infection, Risk factor, Complication, Non Hodgkin lymphoma, Incidence, Histological grading, Histological type, Localization, Epidemiology, Register, United States, North America, America, Prognosis, Human, Immunopathology, Immune deficiency, Malignant hemopathy, Lymphoproliferative syndrome
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0037776
Code Inist : 002B05C02D. Création : 17/04/1998.