Table of Contents
1
UI - 20277954
AU - Fong IW; Ho J; Toy C; Lo B; Fong MW
TI -
Value of long-term administration of acyclovir and similar agents for
protecting against AIDS-related lymphoma: case-control and historical
cohort studies.
SO - Clin Infect Dis 2000 May;30(5):757-61
AD - Department of Medicine, St. Michael's Hospital, University of Toronto,
Ontario, Canada. fongi@smh.toronto.on.ca
Acyclovir or similar agents with activity against Epstein-Barr virus
(EBV) theoretically may prevent non-Hodgkin's lymphoma (NHL) in AIDS. A
case-control study of 29 patients with AIDS-related NHL and 58 matched
control subjects assessed the frequency with which daily acyclovir
(>/=800 mg/d) or similar agents were used for > or =1 year. In a
historical cohort of 304 patients with AIDS for > or =2 years, the
prevalence of NHL was assessed among 3 groups of patients: those who
received long-term treatment with high-dose acyclovir (or similar
agents) or low-dose or intermittent acyclovir; those treated with
ganciclovir/foscarnet for <1 year; and those who had not previously been
treated with acyclovir, ganciclovir, or foscarnet. In the case-control
study, 22 patients (72.4%) with NHL never received acyclovir or similar
drugs versus 19 control subjects (32.8%; P=. 002); 2 patients (6.9%)
with NHL received acyclovir (> or =800 mg/d) for > or =1 year versus 27
(46.6%) of control subjects (P=.0001). In the cohort study, 6 (6.8%) of
88 patients who received acyclovir (> or =800 mg/d) for > or =1 year
developed NHL versus 15 (15.5%) of 97 patients who received intermittent
or lower-dose acyclovir and 30 (25.2%) of 119 patients who never
received these agents (P=.002). Long-term administration (>1 year) of
high-dose acyclovir or similar agents with anti-EBV activity may prevent
NHL in patients with AIDS. A prospective, randomized study is warranted
to confirm these results.
2
UI - 21145200
AU - Grulich AE; Law MG
TI -
Long-term high-dose acyclovir and AIDS-related non-Hodgkins lymphoma.
SO - Clin Infect Dis 2001 Mar 15;32(6):989-90
3
UI - 21245395
AU - Biggar RJ
TI -
AIDS-related cancers in the era of highly active antiretroviral therapy.
SO - Oncology (Huntingt) 2001 Apr;15(4):439-48; discussion 448-9
AD - Viral Epidemiology Branch National Cancer Institute, Bethesda, Maryland,
USA. Biggarb@epndce.nci.nih.gov
Highly active antiretroviral therapy (HAART) has shown great efficacy in
reducing human immunodeficiency virus levels, increasing immunity, and
prolonging the survival of persons with acquired immunodeficiency
syndrome (AIDS). The risk of life-threatening infections has been
greatly reduced. However, the impact of HAART on the incidence of
malignancy has been less clear. Published studies generally show that
the risk of developing Kaposi's sarcoma declined by about two-thirds
between 1994 and 1995 and from 1996 onward (considered the HAART era).
Even before 1994, the risk for Kaposi's sarcoma in persons with AIDS had
declined considerably and this cancer has now become relatively
uncommon. The mechanism by which this decline in incidence was achieved
appears to involve improved immunity. Data on the reduction in the risk
for non-Hodgkin's lymphoma are mixed. Several studies conducted between
1997 and 1999 found no reduction in the risk for non-Hodgkin's lymphoma,
although the most recent data (from 1997 to 1999) show a 42% decrease in
risk. Even with a one-third reduction, the risk for non-Hodgkin's
lymphoma remains considerably elevated. This high risk may be related to
the fact that HAART therapy does not restore the immune system to
normalcy. The increased lymphocyte turnover, with its accompanying risk
of genetic errors, may increase the risk of developing non-Hodgkin's
lymphoma. Most reports have insufficient data to analyze the impact of
HAART therapy on incidence of central nervous system lymphomas, but
recent data (from 1997 to 1999) showed a significant reduction in that
risk. The mechanism by which this might occur is unclear because the
central nervous system is an immunologic sanctuary. The relatively low
incidence of other cancers in persons with AIDS makes it difficult to
gauge the effect of HAART on their incidence, but to date, no
significant trends have been reported for specific tumor types or for
the overall risk of non-AIDS-related cancers.
4
UI - 21290389
AU - Levine AM; Seneviratne L; Tulpule A
TI -
Incidence and management of AIDS-related lymphoma.
SO - Oncology (Huntingt) 2001 May;15(5):629-39; discussion 639-40, 645-6
AD - Keck School of Medicine, University of Southern California, Los Angeles,
California, USA.
Over time, the spectrum of the acquired immune deficiency syndrome
(AIDS) epidemic has changed, especially with the advent of highly active
antiretroviral therapy (HAART). The goal of this article is to delineate
changes occurring in the incidence and management of lymphoma over the
course of the AIDS epidemic. Lymphoma usually occurs rather late in the
course of human immunodeficiency virus (HIV) infection and is the cause
of death in up to 20% of HIV-infected individuals. It is seen in all
population groups at risk for HIV and is more common in men than in
women. It is usually diagnosed in patients with markedly decreased CD4
cell counts, consistent with prolonged periods of HIV infection and
subsequent immunosuppression. Recent data from several large series have
demonstrated a substantial decline in the median CD4 cell count among
patients with newly diagnosed AIDS-related lymphoma despite the recent
widespread use of HAART. While still somewhat controversial, use of
HAART has generally not produced a significant decline in the incidence
of AIDS-related lymphoma. Patients treated with low-dose vs
standard-dose chemotherapy for AIDS-related lymphoma have achieved
similar response and survival rates, although standard-dose therapy is
associated with greater toxicity. Adapting therapy to prognostic factors
has not produced a significant improvement in survival. Use of
antiretroviral therapy along with chemotherapy appears safe, and may be
associated with longer survival. An infusional regimen called EPOCH
(etoposide, prednisone, vincristine [Oncovin], cyclophosphamide,
doxorubicin HCl) shows promise in the future management of AIDS-related
lymphoma. No regimen is currently considered the standard of therapy for
patients with relapsed AIDS-related lymphoma, and survival is short in
this setting.
5
UI - 21450697
AU - Murray PG; Swinnen LJ; Flavell JR; Ragni MV; Baumforth KR; Toomey SM;
TI -
Filipovich AH; Lowe D; Schnell CS; Johl J; Gulley M; Young LS; Ambinder
RF
Frequent expression of the tumor necrosis factor receptor-associated
factor 1 in latent membrane protein 1-positive posttransplant
lymphoproliferative disease and HIV-associated lymphomas.
SO - Hum Pathol 2001 Sep;32(9):963-9
AD - Division of Cancer Studies, University of Birmingham, Edgbaston,
Birmingham, England.
The tumor necrosis factor receptor-associated factor 1 (TRAF1)
participates in the signal transduction of various members of the tumor
necrosis factor receptor (TNFR) family, including TNFR2, CD40, CD30, and
the Epstein-Barr virus (EBV)-encoded latent membrane protein 1 (LMP1).
In vitro, TRAF1 is induced by LMP1, and previous studies have suggested
that expression of TRAF1 is higher in EBV-associated tumors than in
their EBV-negative counterparts. To determine whether this was the case
in posttransplant lymphoproliferative disease (PTLD) and related
disorders, we used immunohistochemistry to analyze expression of TRAF1
in a total of 42 such lesions arising in a variety of immunosuppressive
states. The specimens consisted of 22 PTLD lesions, 18 acquired
immunodeficiency syndrome-associated lymphomas, including 6 primary
central nervous system lymphomas, and 2 cases of Hodgkin disease. The
presence of latent EBV infection was determined by EBER in situ
hybridization, and expression of EBV-LMP1 was detected by
immunohistochemistry. Latent EBV infection, as determined by a positive
EBER signal, was detected in 36 of 42 tumors. Of the EBER-positive
specimens, 30 of 36 also expressed LMP1. Twenty-four of 30 LMP1-positive
tumors, including both Hodgkin disease specimens, expressed TRAF1,
compared with only 3 of 12 LMP1-negative tumors. This difference was
statistically significant (P <.005). These results show frequent
expression of TRAF1 at the protein level in LMP1-positive PTLD and
related disorders and suggest an important role for LMP1-mediated TRAF1
signaling in the pathogenesis of EBV-positive tumors arising in
immunosuppressive states. Copyright 2001 by W.B. Saunders Company
6
UI - 21254045
AU - Ferrozzi F; Tognini G; Mulonzia NW; Bova D; Pavone P
TI -
Primary effusion lymphomas in AIDS: CT findings in two cases.
SO - Eur Radiol 2001;11(4):623-5
AD - Istituto di Scienze Radiologiche, Universita di Parma, Viale Gramsci,
14, 43100 Parma, Italy. ferrozzi@unipr.it
Primary effusion lymphomas represent an unusual subset of AIDS-related
non-Hodgkin's lymphomas. They are associated with herpes virus 8 and
Epstein-Barr virus and characterized by predominant involvement of the
serous body cavities (pleura, pericardium, peritoneum) as lymphomatous
effusion without any identifiable tumour mass. We report herein CT
findings in two patients with primary effusion lymphoma emphasizing the
possible neoplastic nature of a pleural effusion in a patient with AIDS.
7
UI - 21395695
AU - Antinori A; Cingolani A; Alba L; Ammassari A; Serraino D; Ciancio BC;
TI -
Palmieri F; De Luca A; Larocca LM; Ruco L; Ippolito G; Cauda R
Better response to chemotherapy and prolonged survival in AIDS-related
lymphomas responding to highly active antiretroviral therapy.
SO - AIDS 2001 Aug 17;15(12):1483-91
AD - National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS,
Rome, Italy. antinori@inmi.it
OBJECTIVES: To evaluate the impact of response to highly active
antiretroviral therapy (HAART) on the natural history of AIDS
non-Hodgkin's lymphoma (NHL) and to analyse the feasibility, efficacy
and toxicity of HAART in combination with chemotherapy. DESIGN:
Prospective observational study in two AIDS clinical centres in Italy.
METHODS: All consecutive HIV-infected patients with NHL were included (n
= 44; 48% high-risk group) and prospectively followed for 27 months.
HAART was administered concomitantly with chemotherapy. The association
between response to HAART and clinical presentation, response to
chemotherapy and toxicity was analysed by univariate and multivariate
models. Survival analysis was performed by Kaplan-Meier estimates and
the Cox proportional hazards regression model. RESULTS: A complete
response (CR) to chemotherapy was achieved in 71% of HAART responders
and 30% of non-responders. Virological response to HAART was the only
variable associated with tumour response on multivariate analysis. A
higher relative dose intensity (RDI) of chemotherapy was administered in
patients with virological response compared with those without. The
probability of 1 year survival was higher in patients with virological
or immunological response. At Cox regression analysis, immunological
response, a higher RDI and a CR to chemotherapy were all associated with
a reduced risk of death. CONCLUSION: In HIV-infected patients with NHL,
response to HAART was strongly associated with a better response to
chemotherapy and prolonged survival. Concurrent treatments were well
tolerated, and HAART-responder patients could receive a higher RDI of
chemotherapy. In patients with AIDS lymphomas, combining HAART with
chemotherapy could be a feasible and effective approach.
8
UI - 21439157
AU - Clarke CA; Glaser SL
TI -
Epidemiologic trends in HIV-associated lymphomas.
SO - Curr Opin Oncol 2001 Sep;13(5):354-9
AD - Northern California Cancer Center, Union City, California 94587, USA.
tclarke@nccc.org
Infection with HIV increases the risk of developing non-Hodgkin lymphoma
and, to a lesser extent, Hodgkin disease. The introduction of highly
active antiretroviral therapy (HAART) in 1996 changed the natural
history of HIV disease, but the HIV-infected population also has changed
in composition. Accordingly, the epidemiology of HIV-associated
lymphomas now differs from that observed in the first 15 years of the
HIV epidemic. In populations with access to HAART, reductions in
lymphoma risk have been reported for NHL and suggested for Hodgkin
disease, but long-term risks are as yet unknown. Lymphomas are
increasingly common cancers in persons with HIV and are fatal in most
patients, warranting continued attention to their incidence and
etiology.
9
UI - 21443114
AU - Anonymous
TI -
Bibliography. Current World Literature. Cancer in AIDS.
SO - Curr Opin Oncol 2001 Sep;13(5):B139-42
The above citations and abstracts reflect those newly added to CANCERLIT for the month and topic listed in the title. The citations have been retrieved from CANCERLIT using a predefined search strategy of indexed subject terms. Although the search strategy has been refined as best as possible, citations may appear that are not directly related to the topic, and occasionally relevant references may be omitted.
About OncoLink Contact OncoLink Privacy statement Disclaimer Link to OncoLink Home