National Cancer Institute®
Last Modified: July 1, 2002
UI - 11874639
AU - Welch K; Morse A; Adult Spectrum of Disease Project in New Orleans
TI - The clinical profile of end-stage AIDS in the era of highly active antiretroviral therapy.
SO - AIDS Patient Care STDS 2002 Feb;16(2):75-81
AD - Louisiana Office of Public Health, Centers for Disease Control and Prevention, New Orleans, Louisiana, USA. email@example.com
The purpose of this study was to describe the clinical profile of end-stage acquired immune deficiency syndrome (AIDS) since the advent of highly active antiretroviral therapy (HAART). A cross-sectional examination of human immunodeficiency virus (HIV)-infected patients who attended a public HIV outpatient clinic and died between 1996 and 2001 was conducted (n = 669). All clinical and demographic data were collected from the Centers for Disease Control (CDC) Adult Spectrum of Disease database. The prevalence of first-time acquisition of AIDS-defining conditions 12 months before death were evaluated. The prevalence of renal disease, hepatic disease and substance use were also evaluated. The majority of the patients were 35 years old or older, male, African American and HAART-experienced. The six AIDS-defining conditions with the highest percentages of first-time acquisition in the last 12 months of life were HIV dementia (91.8%), progressive multifocal leukoencephalopathy (PML) (91.7%), wasting (90.9%), Mycobacterium avium complex infection (MAC) (80.0%), lymphoma (78.6%), and cytomegalovirus infection (CMV) (78.1%). Forty-four percent of the patients were diagnosed with at least one of these six conditions 12 months before death. More than one third of the patients had renal or hepatic failure, injecting drug use (IDU) as the HIV risk factor, and history of substance use. AIDS-defining conditions continue to have an impact on mortality, especially the neurologic conditions and wasting. However, other conditions, such as renal and hepatic disease, are becoming important causes of mortality because the HIV-infected population now includes more drug users, and HIV-infected patients are surviving for longer periods. These results should help clinicians better time the discussion of end-stage options and improve the patient's quality of life.
UI - 11895917
AU - Alas S; Ng CP; Bonavida B
TI - Rituximab modifies the cisplatin-mitochondrial signaling pathway, resulting in apoptosis in cisplatin-resistant non-Hodgkin's lymphoma.
SO - Clin Cancer Res 2002 Mar;8(3):836-45
AD - Department of Microbiology, Immunology, and Molecular Genetics, University of California Los Angeles School of Medicine and Jonsson Comprehensive Cancer Center, University of California, Los Angeles, California 90095, USA.
PURPOSE: Rituximab (chimeric anti-CD20) can reverse the cisplatin-resistant phenotype of AIDS-related non-Hodgkin's lymphoma cell lines and results in cisplatin-mediated apoptosis. The mechanism by which apoptosis is achieved by the combination treatment was examined. EXPERIMENTAL DESIGN: The AIDS-related lymphoma (ARL) cell line 2F7 was treated with rituximab, cisplatin, and a combination of the two and analyzed by Western blot analyses for signaling proteins involved in the death receptor-mediated and mitochondrial pathways. RESULTS: Rituximab selectively inhibited the expression of Bcl-2 in the ARL cells. However, other proteins analyzed [namely, Apaf-1, Bax, Bid, caspase-3, caspase-8, caspase-9, X-linked inhibitor of apoptosis protein (XIAP), cellular inhibitor of apoptosis protein (cIAP)-1, cIAP-2, cytochrome c, Fas, Fas ligand, FLIP, p53, and poly(ADP-ribose) polymerase] were not affected by either rituximab or cisplatin. Treatment with cisplatin induced the generation of mitochondrial reactive oxygen species, specifically intracellular peroxides. Furthermore, cisplatin alone was unable to induce the mitochondrial apoptotic events; however, the rituximab-cisplatin combination was able to synergistically induce significant apoptosis and mitochondria-mediated apoptotic events [mitochondrial membrane depolarization (DeltaPsi(m)), cytochrome c release from mitochondria, and caspase-3 and -9 activation]. The combination treatment facilitated the down-regulation of Bcl-2 by rituximab at an early time point. Decreased expression of additional proteins (Apaf-1, cIAP-1, cIAP-2, and XIAP) paralleled apoptosis detected at 24 h. CONCLUSIONS: These findings show that the selective down-regulation of Bcl-2 by rituximab leading to apoptosis in ARL cells by cisplatin is through the mitochondria-dependent caspase pathway.
UI - 12033970
AU - Cornfield DB; Papiez JS; Lynch JT; Rimsza LM
TI - Natural killer-like T-cell lymphoma of the parotid in a patient infected with human immunodeficiency virus.
SO - Arch Pathol Lab Med 2002 Jun;126(6):738-41
AD - Department of Pathology, University of Florida College of Medicine, Gainesville, USA. firstname.lastname@example.org
A 42-year-old man with acquired immunodeficiency syndrome developed a mass of the right parotid gland and multiple hepatic masses. Hematoxylin-eosin-stained sections of the parotid lesion showed a diffuse infiltrate of large mononuclear cells with vesicular nuclei and prominent nucleoli, consistent with a non-Hodgkin lymphoma. Immunohistochemical stains demonstrated expression of the T-cell markers CD3 and UCHL-1, as well as latent membrane protein 1 and T-cell intracellular antigen 1. Flow cytometry showed surface expression of CD2, CD3, CD7 (dim), CD8, and CD56. CD5 was not expressed. Molecular evaluation by polymerase chain reaction demonstrated monoclonal rearrangement of the T-cell receptor gamma gene. Epstein-Barr virus early RNA and human immunodeficiency virus RNA were demonstrated by in situ hybridization. To our knowledge, this is the first reported case of T-cell lymphoma of the parotid in a patient infected with human immunodeficiency virus. After 2 separate chemotherapy regimens, the patient achieved clinical remission for 1(1/2) years; he then developed progressive pulmonary lesions and died.
UI - 11976627
AU - Busi Rizzi E; Schinina V; Cristofaro M; Bellussi A; Alba L; Bibbolino C
TI - Primary renal non-Hodgkin's lymphoma with inferior vena cava involvement: report of one case in HIV-infected patient.
SO - Radiol Med (Torino) 2002 Mar;103(3):279-82
AD - Department of Radiology, National Institute for Infectious Diseases L. Spallanzani, Rome, Italy.
UI - 11940475
AU - Ascoli V; Lo Coco F; Torelli G; Vallisa D; Cavanna L; Bergonzi C; Luppi
TI - M Human herpesvirus 8-associated primary effusion lymphoma in HIV--patients: a clinicopidemiologic variant resembling classic Kaposi's sarcoma.
SO - Haematologica 2002 Apr;87(4):339-43
UI - 12055673
AU - Carbone A
TI - AIDS-related non-Hodgkin's lymphomas: from pathology and molecular pathogenesis to treatment.
SO - Hum Pathol 2002 Apr;33(4):392-404
AD - Division of Pathology and Scientific Direction, Centro di Riferimento Oncologico-IRCCS, National Cancer Institute, Aviano, Italy.
In the highly active antiretroviral therapy (HAART) era, AIDS-related non-Hodgkin's lymphomas (AIDS-NHL) and their treatment still represent an open issue, because HAART may not be sufficient to prevent the development of NHL. The present spectrum of AIDS-NHL includes systemic lymphomas, primary central nervous system lymphomas, and 2 rare entities, primary effusion lymphomas (PEL) and plasmablastic lymphomas of the oral cavity. The vast majority of systemic AIDS-NHL belongs to 3 high-grade B-cell lymphomas: Burkitt's lymphoma (BL), immunoblastic lymphoma (IBL), and large-cell lymphoma (LCL). The pathologic heterogeneity of AIDS-NHL is correlated with the heterogeneity of the molecular lesions associated with these lymphomas. The molecular lesions associated with AIDS-BL involve activation of c-MYC inactivation of p53, and infection by Epstein-Barr virus (EBV). EBV infection occurs in 40% of LCL cases and in 90% of IBL cases. Rearrangements of BCL-6 are detected in 20% of AIDS-LCL cases. In the presence of EBV infection, BCL-6 expressing AIDS-LCL fails to express the latent membrane protein 1 (LMP1) antigen. Conversely, AIDS-IBL are characterized by absent BCL-6 expression, absence of BCL-6 rearrangements, and frequent expression of LMP1. Consistently, the molecular pathways of viral infection and lesions of cancer-related genes associated with AIDS-NHL vary substantially in different clinicopathologic categories of the disease. The marked degree of biologic heterogeneity of AIDS-NHL is highlighted by their histogenetic differences, because AIDS-NHL are related to distinct B cell subsets (ie, germinal center [GC] or post-GC B cells). The phenotypic pattern of AIDS-BL and systemic AIDS-LCL closely reflects B cells residing in the GC, namely centroblasts and centrocytes. Conversely, the phenotype of AIDS-IBL, either systemic or localized primarily to the central nervous system, and AIDS-PEL reflects post-GC B cells in all cases. New information on the molecular and virologic pathogenesis of AIDS-NHL may serve as a point of attack for pathogenic-driven therapies. Moreover, a greater knowledge of other biologic features of these tumors may help investigators identify new potential targets for "intelligent" therapies. Copyright 2002, Elsevier Science (USA). All rights reserved.
UI - 7715397
AU - Finn DG
TI - Lymphoma of the head and neck and acquired immunodeficiency syndrome: clinical investigation and immunohistological study.
SO - Laryngoscope 1995 Apr;105(4 Pt 2 Suppl 68):1-18
AD - Department of Otolaryngology--Head and Neck Surgery, New York Eye and Ear Infirmary/New York Medical College, USA.
The epidemic of acquired immunodeficiency syndrome (AIDS) has made an enormous impact in the practice of medicine within the past decade. Of the many associated problems, the increasing frequency of human immunodeficiency virus (HIV)-related malignancies, particularly lymphoma, has been both a fascinating area of study and a most difficult clinical condition to manage. This study investigates lymphoma of the head and neck with clinical studies, as well as immunohistochemical assessments from individual patients. Lymphomas of the head and neck, as they present to the otolaryngologist, can present difficult and challenging diagnostic and therapeutic dilemmas. It is well-known that a significant number of acquired immunodeficiency patients present initially with symptoms related to the otolaryngology field; it was also found that a certain number of lymphomas in the head and neck in HIV+ patients are the initial presentation. In addition, the associated disorders, such as related infections and synchronous additional neoplasms, are described. Also presented are recommendations for diagnosis and work-up of these conditions, based on the experience. In addition, the study of lymphoma as a neoplasm from the molecular biology viewpoint and its course in the immunodeficient state have been important areas of study in an effort to dissect the progression to oncogenesis. The rapidly expanding literature base in this area is discussed.
UI - 12102166
AU - Baiocchi OC; Colleoni GW; Navajas EV; Duarte LC; Alves AC; Andrade AL;
TI - Kerbauy J; Oliveira JS Impact of highly active antiretroviral therapy in the treatment of HIV-infected patients with systemic non-Hodgkin's lymphoma.
SO - Acta Oncol 2002;41(2):192-6
AD - Hematology and Transfusion Service, Universidade Federal de Sao Paulo, Brazil.
Twenty cases of systemic non-Hodgkin's lymphoma (NHL) in HIV-infected patients were reviewed over a 10-year-period, divided into Group A, including 13 NHL cases treated before the highly active antiretroviral therapy (HAART) era, and Group B, including 7 patients who received HAART. A Kaplan-Meier survival curve was performed and log-rank was applied to assess statistical differences between the groups. In group A, the median CD4 count was 36 cells/mm3. No complete remission was found. In group B, the median CD4 count was 137 cells/mm3. Four patients (57.0%) are still alive and in complete remission. Group A had a median survival of 5 months and group B 31 months (p = 0.0032). Our results are in agreement with recent reports in that a higher CD4 count and better immune status achieved with HAART is predictive of a better outcome. We found that HAART in combination with chemotherapy improves overall survival of NHL patients without increasing adverse effects.
UI - 11765662
AU - Juzbasic S; Spina M; Vaccher E; Tirelli U
TI - [Systemic HIV-non-Hodgkin lymphoma in the era of HAART. Natural history]
SO - Recenti Prog Med 2001 Nov;92(11):676-89
AD - Divisione di Oncologia Medica A, Istituto Nazionale Tumori, Centro di Riferimento Oncologico, Aviano.
In the era of highly active antiretroviral therapy (HAART), systemic non-Hodgkin lymphoma (NHL) represented the most frequent cancer associated to HIV infection. In contrast to Kaposi's sarcoma and primary central nervous system lymphoma (PCNSL) which incidence have been declining after introduction of HAART, systemic NHL-HIV has relatively stable remained. Systemic HIV related NHL are markedly heterogeneous both histologically and clinically and this clinicophatological heterogenity reflects variability in the molecular lesions associated to these lymphomas and immunological status of these patients. The introduction of HAART has substantially modified the approach to HIV related lymphomas. The results of recent monoinstitutional study of Aviano Cancer's Institute on 235 patients have suggested that HAART would otherwise allow a long life expectancy with longer disease free survival and overall survival. In fact the reduced of morbidity of AIDS patients bought by HAART justified the use of aggressive antineoplastic therapies.
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