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Characteristics of indolent non‐hodgkin lymphoma in patients with type 1 human immunodeficiency virus infection
Author(s) -
Levine Alexandra M.,
Sadeghi Saeed,
Espina Byron,
Tulpule Anil,
Nathwani Bharat
Publication year - 2002
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.10368
Subject(s) - medicine , lymphoma , non hodgkin's lymphoma , marginal zone , follicular lymphoma , incidence (geometry) , working formulation , gastroenterology , pathology , b cell , immunology , antibody , physics , optics
BACKGROUND There is recent evidence that the incidence of indolent non‐Hodgkin lymphoma (NHL) appears to be increased in persons with the acquired immunodeficiency syndrome (AIDS). The current study was conducted to describe the clinical, immunologic, and pathologic characteristics of indolent B‐cell lymphoma in patients infected with the human immunodeficiency virus (HIV). METHODS The current report was a retrospective study of 10 cases of indolent NHL identified from the AIDS‐Lymphoma Registry at the University of Southern California School of Medicine. These patients were compared with 336 consecutive patients with systemic intermediate/high‐grade AIDS‐related NHL who were diagnosed and treated at a single institution. RESULTS The pathology of the indolent cases included follicular lymphoma (five patients), small lymphocytic lymphoma (two patients), and one case each of mucosa‐associated lymphoid tissue (MALT), monocytoid B‐cell, and marginal zone lymphoma. When comparing the indolent lymphomas with the intermediate/high‐grade AIDS‐NHL cases, no differences were observed with regard to demographic characteristics or history of prior opportunistic infection. HIV patients with indolent lymphomas were found to have a significantly higher median CD4+ lymphocyte count compared with patients with intermediate/high‐grade NHL (531 /mm 3 vs. 90 /mm 3 ) ( P < 0.0001). Bone marrow involvement was significantly more common in indolent NHL cases (50%) versus intermediate/high‐grade NHL cases (17%) ( P = 0.02). The median survival for patients with indolent NHL was significantly longer compared with patients with intermediate/high‐grade NHL (66.8 months vs. 7.1 months) ( P = 0.007). CONCLUSIONS Indolent lymphomas occurring in patients infected with HIV appear to differ from intermediate/high‐grade lymphomas with regard to immune status and propensity for bone marrow involvement and prolonged survival. The median survival in the group of HIV‐seropositive patients with indolent NHL examined in the current study was found to be comparable to that reported in HIV‐negative individuals. Cancer 2002;94:1500–6. © 2002 American Cancer Society. DOI 10.1002/cncr.10368