HOUSTONPhysicians at Ben Taub General Hospital, Houston, noticed that an unusual number of patients were presenting with lymphoma as their first AIDS-defining event. This observation prompted a retrospective study of all HIV-positive patients with non-Hodgkin’s lymphoma presenting between 1989 and 2000.
Indeed, the analysis showed that 33 (35%) of the 88 patients identified in the study were newly diagnosed with HIV, whereas 55 were known to be HIV positive when their lymphoma was diagnosed, Suleiman Alfred Massarweh, MD, told ONI in an interview. In other cohorts of patients with HIV-related lymphoma, he noted, only 3% to 5% typically present with lymphoma as their first AIDS-defining illness.
This discrepancy may be explained, in part, by Ben Taub’s status as a community hospital. The hospital serves as the first destination for these patients at presentation, thus eliminating potential referral bias. "Most patients in the large cohorts already have their HIV diagnosis when they go to these referral centers," Dr. Massarweh said at the 43rd Annual Meeting of the American Society of Hematology (abstract 1434). He is a clinical fellow at Baylor College of Medicine.
The substantial number of newly diagnosed HIV patients with lymphoma in the Ben Taub database gave the Houston researchers a unique opportunity to compare these patients with lymphoma patients with known HIV infection.
Of the 55 known-HIV patients presenting with lymphoma in the study, 10 had no history of an AIDS-defining illness and were being followed by primary care physicians in the HIV clinic. The rest had a previous AIDS-defining event before their lymphoma presentation.
Dr. Massarweh noted that the new-HIV lymphoma patients tended to be a few years older than the known-HIV patients: an average of 41 vs 38 years.