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November NaN, 2000

Estimating the Risk of Cancer in Children With AIDS—Reply

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor

JAMA. 2000;284(20):2593-2594. doi:10.1001/jama.284.20.2591

In Reply: We did not analyze the effect of therapy because of limited data. Most US children with AIDS were born between 1987 (when therapy first became available) and 1994, before the era of highly active therapy. Thus, most children had the opportunity to receive antiretroviral therapy of some type. However, AIDS registries are not reliable sources of information about individual therapy.

Mr Gallagher and Dr Wang question our inclusion of brain lymphomas in the analysis when these were reported only in the AIDS registry data. As explained in our article, we were presented with an unusual finding in the analysis. More than half (12) of the 23 cases of primary brain lymphoma recorded in children were known only from the AIDS registry data. For 2 other cases, the diagnosis was primary brain lymphoma in the AIDS registry but the cancer registry information simply listed non-Hodgkin lymphoma. Among the remainder, 5 cases were known from both AIDS and cancer registry data, and 4 cases were known only from the cancer registry. Thus, had we restricted diagnoses of primary brain lymphoma to the cancer registry data, we would have used only 39% of the reported cases. In contrast, among children with AIDS who had known nonbrain lymphomas, 71% of cases were found in the cancer registries, a proportion similar to that found in adults with AIDS.

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