home
***
CD-ROM
|
disk
|
FTP
|
other
***
search
/
Software Vault: The Sapphire Collection
/
Software Vault (Sapphire Collection) (Digital Impact).ISO
/
cdr16
/
med9410d.zip
/
M94A0715.TXT
< prev
next >
Wrap
Text File
|
1994-10-21
|
4KB
|
60 lines
Document 0715
DOCN M94A0715
TI Clinical management of HIV-related malignancies.
DT 9412
AU Volberding P; San Francisco General Hospital.
SO Annu Conf Australas Soc HIV Med. 1993 Oct 28-30;5:23 (abstract no.
FPI-3). Unique Identifier : AIDSLINE ASHM5/94348940
AB Two cancers are recognised as occurring in a higher rate in patients
with HIV infection. These include non-Hodgkin's B cell lymphomas and
Kaposi's sarcoma. In addition, some data indicates that Hodgkin's
disease may also occur at an increased incidence. Many other
malignancies have been reported in patients infected with HIV and the
natural history of these malignancies may well be altered in the setting
of a viral-induced immune deficiency. Kaposi's sarcoma remains the most
common HIV-related malignancy, although its incidence is decreasing in
all populations. Kaposi's sarcoma appears from epidemiologic evidence to
be induced by a second pathogen in addition to HIV, although the nature
of this probably enteric infection is unknown. The diagnosis of Kaposi's
sarcoma ideally is made both visually and histologically as other
conditions, especially bacillary angiomatosis can closely resemble this
malignancy. Therapy for Kaposi's sarcoma is individualised. Slowly
progressing disease may not require systemic treatment and local
therapies can be used for facial lesions in particular. Systemic
chemotherapy with vinca alkaloids is often used for early disease while
more aggressive disease, especially involving the lungs, requires more
aggressive combination chemotherapy, typically with combinations of
adriamycin, bleomycin and vincristine. Newer biologic therapies are
being developed. Non-Hodgkin's lymphomas in HIV infection occur at an
increased rate and two main types of lymphomas are seen. These include
central nervous system disease and peripheral non-Hodgkin's lymphomas.
Central nervous systems lymphomas are essentially all EBV-related and
occur in patients with severely depleted CD4 cell count. Peripheral
lymphomas occur in patients with a more intact immune system and many
are not EBV-associated. Peripheral B cell lymphomas in HIV are often
extra nodal and disseminated and respond less completely to therapy than
in the HIV uninfected patient. Aggressive chemotherapy is required
although a bone marrow tolerance for aggressive chemotherapy is
frequently dose-limiting. Therapy of HIV-related non-Hodgkin's lymphomas
has been improved with the availability of bone marrow growth factor
support, especially GCSF. The treatment of CNS lymphomas in HIV
infection is, at best palliative. Radiation therapy is used, although
survival is limited and response to therapy is often incomplete. Other
malignancies in HIV infection, while not necessarily occurring at an
increased incidence, have a more aggressive clinical course. The most
important of these malignancies include cervical malignancies in women
and anal squamous cell carcinomas in men. Routine cytologic examination
for these cancers should be included in HIV management and these and
other cancers should be treated as appropriate but considering the
patient's disease stage.
DE Antineoplastic Agents, Combined/THERAPEUTIC USE Anus Neoplasms/THERAPY
Carcinoma, Squamous Cell/THERAPY Cervix Neoplasms/THERAPY
Chemotherapy, Adjuvant Combined Modality Therapy Female Human HIV
Infections/*THERAPY Lymphoma, AIDS-Related/THERAPY Male
Neoplasms/*THERAPY Sarcoma, Kaposi's/THERAPY Skin Neoplasms/THERAPY
MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).