Incidence of AIDS- and non-AIDS-defining malignomas in HIV-positive patients—A nation-wide German overview 2000–2002

Abstract

7554 Background: The primary purpose of this study was to gather data on the epidemiology of AIDS- and non-AIDS-defining malignomas in HIV-positive patients nation-wide in Germany. The secondary objective was to obtain information on their therapy and outcomes. Methods: Surveys were conducted targeting all HIV-specialty clinics and ambulatory care centres as well as all members of the national society of oncologists (BNHO). The surveys requested information on all AIDS- and non-AIDS-defining hematological neoplasms and solid tumors over 3 years (2000–2002) in HIV-positive patients, their tumor stage, their treatments and their clinical course. Further parameters were the CDC (Center for Disease Control)-stage of the HIV-infection and for 2002 the sex of the patient. Results: 60 centres participated in the evaluation and provided 382 data sets. Two data sets were dismissed, where the diagnosis was not made within the defined time frame. Thus 380 data sets from 376 patients could be evaluated (4 patients had 2 malignomas). 180 (47.4%) were AIDS-defining as follows: 89 Kaposi Sarcomas, 82 aggressive B-cell lymphomas, 9 invasive cervix carcimomas. The B-cell lymphomas further included 19 Burkitt’s lymphomas, 8 Castleman diseases, 12 primary cerebral lymphomas. Among the 200 cases (52.6%) of non-AIDS defining malignomas were 133 solid tumors including 40 anal carcinomas (= 20.0% of all non-AIDS defining malignancies) and 67 hemoblastoses including 22 Hodgkin lymphomas (= 11% of all non-AIDS defining malignancies). Conclusions: Our observation showed an unexpected high incidence of non AIDS-defining malignomas over the 3-year time interval followed. Anal carcinomas and M. Hodgkin lymphomas in particular were markedly more prevalent in our HIV-positive cohort compared to published reports of the general population. A conservative estimate showed the incidence of Hodgkin lymphomas to be 6- to 17-times higher, and that of anal carcinomas to be 30- to 60-times elevated. No significant financial relationships to disclose.