Document 2381
 DOCN  M94A2381
 TI    Malignant outcomes from a cross-study analysis of patients participating
       in a community-based clinical trials program. Community Programs for
       Clinical Research on AIDS (CPCRA), NIAID, NIH.
 DT    9412
 AU    Abrams DI; Wentworth DR; Neaton JD; Sherer R; Deyton L; San Francisco
       General Hospital, CA 94110.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):317 (abstract no. PC0199). Unique
       Identifier : AIDSLINE ICA10/94370194
 AB    PURPOSE: To identify predictors of malignancies in a large cohort of
       patients enrolled in studies sponsored by the Terry Beirn Community
       Programs for Clinical Research on AIDS (CPCRA) and to describe the
       survival experience of those who develop AIDS-related malignancies.
       METHODS: Cross-study data collected using standardized procedures by 17
       centers were the basis for this investigation. Between September 1990
       and September 1993, 3,705 patients with a baseline CD4+ T lymphocyte
       count (CD4) < 500 cells/mm3 were enrolled in one or more of 11 studies
       sponsored by the CPCRA. Predictors of mucocutaneous Kaposi's sarcoma
       (MKS), visceral KS (VKS), and lymphoma were investigated using
       proportional hazards regression. Cumulative incidence and mortality
       following one of these events was estimated using the Kaplan-Meier
       method. RESULTS: 15% of the 3,705 patients studied were women; 34% were
       black and 13% were Latino. Approximately 29% had a history of injecting
       drug use (IDU). Most men (75%) reported homosexual activity. Average
       CD4+ was 153 cells/mm3. A history of MKS was found in 196 patients
       (5.3%) at entry; 15 (0.4%) had a history of VKS; 16 (0.4%) had a history
       of lymphoma. Each of these malignancies occurred rarely in the 565 women
       under followup. Two women developed MKS during the followup, none VKS,
       and 3 lymphoma. Cervical malignancies were also rare (2 women). In
       contrast, among the 2950 men followed, one year incidence was 4.5% for
       MKS, 1.4% for VKS, and 1.6% for lymphoma. Among men incidence varied
       significantly by CD4 count (p < 0.001). For those with baseline CD4+ <
       50 cells/mm3 one year cumulative incidence was 8.3% for MKS, 3.4% for
       VKS, and 3.9% for lymphoma. For those with baseline CD4 count 50-99,
       corresponding percents were 6.8, 2.2, and 1.9%. Above 100 cells/mm3, VKS
       and lymphoma occurred in less than 1% of patients. For MKS, one year
       incidence was 4.7% for those with baseline CD4 count 100-199, 1.4% for
       those with CD4 200-299, and less than 1% for those with 300+ cells/mm3.
       Homosexual activity was also associated with an increased risk for MKS
       (RR = 4.5, p = 0.001) and VKS (RR = 5.3, p = 0.12). Age, IDU and race
       were not associated with MKS, VKS or lymphoma after adjustment for CD4
       count. Mortality following the development of these malignancies was
       high-at one year it was 40.3% for MKS, 68.4% for VKS, and 84.1% for
       lymphoma. CONCLUSIONS: Risk of AIDS-related malignancies increase with
       declining CD4 count; malignancies occur rarely in women and at similar
       rates among ethnic groups. Prognosis following malignant disease is
       poor.
 DE    Acquired Immunodeficiency Syndrome/*COMPLICATIONS/IMMUNOLOGY  Cervix
       Neoplasms/COMPLICATIONS  Female  Human  Leukocyte Count  Lymphoma,
       AIDS-Related/*EPIDEMIOLOGY  Male  Risk Factors  Sarcoma,
       Kaposi's/*EPIDEMIOLOGY/ETIOLOGY  Sex Behavior  Substance Abuse,
       Intravenous/COMPLICATIONS  T4 Lymphocytes  MEETING ABSTRACT  MULTICENTER
       STUDY

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       protected by Copyright Law (Title 17, U.S.Code).