Document Detail


AIDS-related malignancies: emerging challenges in the era of highly active antiretroviral therapy.
MedLine Citation:
PMID:  15967835     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Human immunodeficiency virus (HIV)-infected patients are at increased risk of developing cancer, particularly in the later stages of acquired immune deficiency syndrome (AIDS). Despite the advent of highly active anti-retroviral therapy (HAART), malignancy in this population is a leading cause of morbidity and mortality. Kaposi's sarcoma (KS) and AIDS-related non-Hodgkin's lymphoma (ARL) are the most common AIDS-defining malignancies. AIDS-related KS varies from minimal to fulminant disease. Treatment decisions for AIDS-related KS are guided largely by the presence and extent of symptomatic disease. In addition to HAART, excellent treatments exist for both localized disease (topical gel, radiotherapy, and intralesional therapy) and advanced disease (liposomal anthracyclines, paclitaxel). Novel therapies that have become available to treat AIDS-related KS include angiogenesis inhibitors and antiviral agents. ARL comprises a heterogeneous group of malignancies. With the immune restoration afforded by HAART, standard-dose chemotherapies now can be safely administered to treat ARL with curative intent. The role of analogous treatments used in HIV-negative patients, including monoclonal antibodies and autologous stem cell transplantation, requires further clarification in HIV-positive patients. HIV-infected patients also appear to be at increased risk for developing certain non-AIDS-defining cancers, such as Hodgkin's lymphoma and multiple myeloma. Although the optimal treatment of these neoplasms is at present uncertain, recent advances in chemotherapy, antiretroviral drugs, and supportive care protocols are allowing for more aggressive management of many of the AIDS-related cancers. This article provides an up-to-date review of the epidemiology, pathogenesis, clinical features, and treatment of various AIDS-related malignancies that are likely to be encountered by an oncologist practicing in the current HAART era.
Authors:
Matthew C Cheung; Liron Pantanowitz; Bruce J Dezube
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  The oncologist     Volume:  10     ISSN:  1083-7159     ISO Abbreviation:  Oncologist     Publication Date:    2005 Jun-Jul
Date Detail:
Created Date:  2005-06-21     Completed Date:  2005-12-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9607837     Medline TA:  Oncologist     Country:  United States    
Other Details:
Languages:  eng     Pagination:  412-26     Citation Subset:  IM    
Affiliation:
Sunnybrook and Women's College Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Acquired Immunodeficiency Syndrome / complications*
Antiretroviral Therapy, Highly Active*
Education, Medical, Continuing
Hodgkin Disease / drug therapy*,  etiology,  pathology
Humans
Lymphoma, AIDS-Related / drug therapy*,  etiology,  pathology
Lymphoma, Non-Hodgkin / drug therapy*,  etiology,  pathology
Medical Oncology / trends*
Prognosis
Risk Factors
Sarcoma, Kaposi / drug therapy*,  etiology,  pathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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