Clinical Manual for Management of the HIV-Infected ... - myCME.com

Non-Hodgkin Lymphoma
Background
Non-Hodgkin lymphoma (NHL) is a diverse group of
more than 20 malignant diseases originating in the cells
of the immune system. The incidence of NHL is up to
60 times higher in HIV-infected patients than in HIVnoninfected
persons, and the risk of NHL increases
with declining immune function. In the United States,
rates of NHL among HIV-infected persons increased
dramatically in the early years of the HIV epidemic, but
the rate has stabilized since the advent of antiretroviral
therapy (ART).
Ninety percent of HIV-related NHL cases are of
B-cell origin and they are frequently high-grade in
nature. Although B-cell lymphomas may occur at any
stage of HIV disease, they are seen more frequently
in patients with lower CD4 cell counts (particularly
CD4 counts of