Todd M Gibson1, Lindsay M Morton, Meredith S Shiels, Christina A Clarke, Eric A Engels. 1. aDivision of Cancer Epidemiology and Genetics bCancer Prevention Fellowship Program, National Cancer Institute, Bethesda, Maryland cCancer Prevention Institute of California, Fremont, California, USA. *Current affiliation: Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, Tennessee, USA.
Abstract
OBJECTIVE: HIV-infected people have greatly elevated risk of non-Hodgkin lymphoma (NHL), particularly the AIDS-defining NHL subtypes: diffuse large B-cell lymphoma, Burkitt lymphoma and primary lymphomas arising in the central nervous system. The goals of this analysis were to comprehensively describe risks of NHL subtypes, especially those not well studied, among HIV/AIDS patients; examine risks specifically in the HAART era; and distinguish risks in HIV-infected individuals prior to diagnosis with AIDS. DESIGN: Population-based registry linkage study. METHODS: We used data from the US HIV/AIDS Cancer Match Study from 1996 to 2010 (N = 273 705) to calculate standardized incidence ratios (SIRs) comparing subtype-specific NHL risks in HIV-infected people to those in the general population, and used Poisson regression to test for differences in SIRs between the HIV-only and AIDS periods. RESULTS: NHL risk was elevated 11-fold compared to the general population, but varied substantially by subtype. AIDS-defining NHL subtypes comprised the majority, and risks were high (SIRs ≥17), but risks were also increased for some T-cell lymphomas (SIRs = 3.6-14.2), marginal zone lymphoma (SIR = 2.4), lymphoplasmacytic lymphoma/Waldenström macroglobulinemia (SIR = 3.6), and acute lymphoblastic leukemia/lymphoma (SIR = 2.4). CONCLUSION: HIV-infected people in the HAART era continue to have elevated risk of AIDS-defining NHL subtypes, highlighting the contribution of moderate and severe immunosuppression to their cause. Whereas non-AIDS-defining subtypes are much less common, immunosuppression or other dysregulated immune states likely play a role in the cause of some T-cell lymphomas, marginal zone lymphoma, lymphoplasmacytic lymphoma/Waldenström macroglobulinemia, and acute lymphoblastic leukemia/lymphoma.
OBJECTIVE:HIV-infected people have greatly elevated risk of non-Hodgkin lymphoma (NHL), particularly the AIDS-defining NHL subtypes: diffuse large B-cell lymphoma, Burkitt lymphoma and primary lymphomas arising in the central nervous system. The goals of this analysis were to comprehensively describe risks of NHL subtypes, especially those not well studied, among HIV/AIDSpatients; examine risks specifically in the HAART era; and distinguish risks in HIV-infected individuals prior to diagnosis with AIDS. DESIGN: Population-based registry linkage study. METHODS: We used data from the US HIV/AIDS Cancer Match Study from 1996 to 2010 (N = 273 705) to calculate standardized incidence ratios (SIRs) comparing subtype-specific NHL risks in HIV-infected people to those in the general population, and used Poisson regression to test for differences in SIRs between the HIV-only and AIDS periods. RESULTS: NHL risk was elevated 11-fold compared to the general population, but varied substantially by subtype. AIDS-defining NHL subtypes comprised the majority, and risks were high (SIRs ≥17), but risks were also increased for some T-cell lymphomas (SIRs = 3.6-14.2), marginal zone lymphoma (SIR = 2.4), lymphoplasmacytic lymphoma/Waldenström macroglobulinemia (SIR = 3.6), and acute lymphoblastic leukemia/lymphoma (SIR = 2.4). CONCLUSION:HIV-infected people in the HAART era continue to have elevated risk of AIDS-defining NHL subtypes, highlighting the contribution of moderate and severe immunosuppression to their cause. Whereas non-AIDS-defining subtypes are much less common, immunosuppression or other dysregulated immune states likely play a role in the cause of some T-cell lymphomas, marginal zone lymphoma, lymphoplasmacytic lymphoma/Waldenström macroglobulinemia, and acute lymphoblastic leukemia/lymphoma.
Authors: A M Levine; R Nelson; E Zuckerman; T Zuckerman; S Govindarajan; B Valinluck; L Bernstein Journal: J Acquir Immune Defic Syndr Hum Retrovirol Date: 1999-03-01
Authors: Eric A Engels; Ruth M Pfeiffer; James J Goedert; Phillip Virgo; Timothy S McNeel; Steven M Scoppa; Robert J Biggar Journal: AIDS Date: 2006-08-01 Impact factor: 4.177
Authors: Eric A Engels; Robert J Biggar; H Irene Hall; Helene Cross; Allison Crutchfield; Jack L Finch; Rebecca Grigg; Tara Hylton; Karen S Pawlish; Timothy S McNeel; James J Goedert Journal: Int J Cancer Date: 2008-07-01 Impact factor: 7.396
Authors: Lindsay M Morton; Todd M Gibson; Christina A Clarke; Charles F Lynch; Dennis D Weisenburger; Eric A Engels Journal: Haematologica Date: 2014-02-21 Impact factor: 11.047
Authors: Shunyou Gong; Genevieve M Crane; Chad M McCall; Wenbin Xiao; Karthik A Ganapathi; Nathan Cuka; Theresa Davies-Hill; Liqiang Xi; Mark Raffeld; Stefania Pittaluga; Amy S Duffield; Elaine S Jaffe Journal: Am J Surg Pathol Date: 2018-10 Impact factor: 6.394
Authors: D Germini; T Tsfasman; M Klibi; R El-Amine; A Pichugin; O V Iarovaia; C Bilhou-Nabera; F Subra; Y Bou Saada; A Sukhanova; D Boutboul; M Raphaël; J Wiels; S V Razin; S Bury-Moné; E Oksenhendler; M Lipinski; Y S Vassetzky Journal: Leukemia Date: 2017-03-31 Impact factor: 11.528
Authors: Shukaib Arslan; Mark R Litzow; Nathan W Cummins; Stacey A Rizza; Andrew D Badley; Willis Navarro; Shahrukh K Hashmi Journal: Biol Blood Marrow Transplant Date: 2019-03-26 Impact factor: 5.742
Authors: David J Riedel; Kristen A Stafford; Aparna Vadlamani; Robert R Redfield Journal: AIDS Res Hum Retroviruses Date: 2016-12-13 Impact factor: 2.205
Authors: Eric A Engels; Ruth Parsons; Caroline Besson; Lindsay M Morton; Lindsey Enewold; Winnie Ricker; Elizabeth L Yanik; Hannah Arem; April A Austin; Ruth M Pfeiffer Journal: Cancer Epidemiol Biomarkers Prev Date: 2016-04-26 Impact factor: 4.254