AIDS-ASSOCIATED NON-HODGKINS-LYMPHOMAS AS PRIMARY AND SECONDARY AIDS DIAGNOSES IN HEMOPHILIACS

We studied the characteristics and temporal trends of AIDS-associated non-Hodgkin's lymphoma (AIDS-NHL) in individuals with hemophilia. Pros pective data were collected on 33 HIV-positive hemophiliacs with AIDS- NHL enrolled in the Hemophilia Malignancy Slurry (HMS), of whom 21 had primary and 12 had secondary or subsequent AIDS-defining illnesses, a nd analyzed for frequency and temporal trends. As compared with primar y AIDS-NHL, secondary AIDS-NHL occurred at an older mean age, 37 versu s 29 years (p = 0.12); at a lower mean CD4 count, 46 versus 154 (p = 0 .07); after a longer period of immunosuppression (CD4 < 200/mu l), 41 versus 16 months (p = 0.03); and with shorter median survival, 2 versu s 7 months (p = 0.09). The presence of EBV in tumor tissue was associa ted with shorter survival, 1 versus 7 months (p = 0.17). Between 1981 and 1988 and 1989 and 1994, the proportion of primary AIDS diagnoses t hat were ALDS-NHL changed minimally, 4.6 versus 6.1%, whereas there we re significant decreases in Pneumocystis carinii pneumonia (PCP, p = 0 .02) and wasting (p = 0.07), and an increase in Candida (p = 0.004). T hese findin,gs confirm that an increasing proportion of AIDS-NHL in he mophiliacs are occurring as secondary or later AIDS diagnoses, and the y are associated with prolonged duration of immunosuppression.