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Blood, 15 October 2001, Vol. 98, No. 8, pp. 2339-2344
CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS
Changes in AIDS-related lymphoma since the era of highly active
antiretroviral therapy
Caroline Besson,
Aicha Goubar,
Jean Gabarre,
Willy Rozenbaum,
Gilles Pialoux,
François-Patrick Châtelet,
Christine Katlama,
Frédéric Charlotte,
Bertrand Dupont,
Nicole Brousse,
Michel Huerre,
Jacqueline Mikol,
Philippe Camparo,
Karima Mokhtari,
Micheline Tulliez,
Dominique Salmon-Céron,
François Boué,
Dominique Costagliola, and
Martine Raphaël
From Hôpital Necker, SC4-INSERM, CHU Pitié
Salpêtrière, Hôpital Rothschild, Hôpital de
l'Institut Pasteur, Hôpital Lariboisière, Hôpital du
Val de Grâce, Hôpital Cochin, all of Paris, France;
Hôpital Antoine Béclère, Clamart, France; CHU
Avicenne, EA 1625, UFR SMBH Léonard de Vinci, Université
Paris 13, Bobigny, France.
HIV infection is associated with a high incidence of AIDS-related
lymphomas (ARLs). Since the use of highly active antiretroviral therapy
(HAART), the incidence of AIDS-defining illnesses has decreased,
leading to a significant improvement in survival of HIV-infected
patients. The consequences of HAART use on ARL are under debate. This
study compared the incidence and the characteristics of ARL before and
after the use of HAART in a large population of HIV-infected patients
in the French Hospital Database on HIV (FHDH) and particularly in 3 centers including 145 patients with proven lymphoma. Within the FHDH,
the incidence of systemic ARL has decreased between 1993-1994 and
1997-1998, from 86.0 per 10 000 to 42.9 per 10 000 person-years
(P < 10 30). The incidence of primary brain
lymphoma has also fallen dramatically between the periods, from 27.8 per 10 000 to 9.7 per 10 000 person-years (P < 1011). The analysis of 145 cases of
ARL in 3 hospitals showed that known HIV history was longer in the
second period than in the first period among patients with systemic ARL
(98 versus 75 months; P < .01). Patients had a higher
number of CD4 cells at diagnosis during the second period (191 versus
63/µL, P = 103). Survival of patients
with systemic ARL also increased between the periods (from 6 to 20 months; P = .004). Therefore, the profile of ARL has
changed since the era of HAART, with a lower incidence of systemic and
brain ARL. The prognosis of systemic ARL has improved.
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