Moore R D, Kessler H, Richman D D, Flexner C, Chaisson R E
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Md.
JAMA. 1991 May 1;265(17):2208-11.
We wished to determine the incidence of human immunodeficiency virus-related high-grade non-Hodgkin's lymphoma (NHL) and identify factors associated with the development of NHL in patients receiving zidovudine. Data are from a 2-year prospective, observational, multisite study of 1030 patients with the acquired immunodeficiency syndrome (AIDS) and advanced AIDS-related complex who received zidovudine. Non-Hodgkin's lymphoma developed in 24 (2.3%) of 1030 patients who received zidovudine during 1463 person-years of follow-up (rate, 1.6 per 100 person-years of therapy). The relative hazard for development of NHL was stable throughout 2 years of therapy, with the risk of developing NHL 0.8% for each additional 6 months of therapy. Factors associated with development of NHL were a prior diagnosis of Kaposi's sarcoma, herpes simplex virus infection, or lower mean neutrophil count. Less strongly associated was a prior diagnosis of oral hairy leukoplakia or homosexual transmission of HIV. By Cox proportional hazards analysis, a prior diagnosis of Kaposi's sarcoma, cytomegalovirus disease, or oral hairy leukoplakia was most strongly associated with development of NHL. Our study demonstrates a relatively high incidence of NHL in patients with advanced human immunodeficiency virus disease who are undergoing antiretroviral therapy and suggests possible risk factors for development of NHL.
我们希望确定人类免疫缺陷病毒相关的高级别非霍奇金淋巴瘤（NHL）的发病率，并识别接受齐多夫定治疗的患者中与NHL发生相关的因素。数据来自一项针对1030例获得性免疫缺陷综合征（AIDS）患者和晚期AIDS相关综合征患者的为期2年的前瞻性、观察性、多中心研究，这些患者均接受了齐多夫定治疗。在1463人年的随访期间，接受齐多夫定治疗的1030例患者中有24例（2.3%）发生了非霍奇金淋巴瘤（发病率为每100人年治疗1.6例）。在整个2年的治疗过程中，NHL发生的相对风险保持稳定，每增加6个月的治疗，发生NHL的风险为0.8%。与NHL发生相关的因素包括既往诊断为卡波西肉瘤、单纯疱疹病毒感染或较低的平均中性粒细胞计数。既往诊断为口腔毛状白斑或HIV通过同性恋传播与之相关性较弱。通过Cox比例风险分析，既往诊断为卡波西肉瘤、巨细胞病毒病或口腔毛状白斑与NHL发生的相关性最强。我们的研究表明，正在接受抗逆转录病毒治疗的晚期人类免疫缺陷病毒病患者中NHL的发病率相对较高，并提示了NHL发生的可能风险因素。
