Hematologic and oncologic aspects of HIV infection:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
1996
|
| Schriftenreihe: | Hematology, oncology clinics of North America
10,5 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XIV S., S. 997 - 1219 Ill., graph. Darst. |
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Datensatz im Suchindex
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| adam_text | HEMATOLOGIC AND ONCOLOGIC ASPECTS OF HIV INFECTION
CONTENTS
Preface xiii
Susan E. Krown and Jamie H. Von Roenn
The Epidemiology of AIDS Related Neoplasms 997
Robert J. Biggar and Charles S. Rabkin
The magnitude for and risk factors of the two most important
AIDS neoplasms, Kaposi s sarcoma and non Hodgkin s lym
phoma, are reviewed in detail. The association between AIDS
and other cancers is mostly speculative because surveillance bi¬
ases tend to favor detecting associations that may be spurious.
The overall relative risk of other cancers appears, however, to be
only twofold above that in the general population, with associa¬
tions being most convincing for anal (but not cervical) cancer
and leiomyosarcoma and possible also for Hodgkin s disease,
testicular cancer, and conjunctival cancers.
Pathogenesis of AIDS Related Kaposi s Sarcoma:
Evidence of a Viral Etiology 1011
Steven A. Miles
Kaposi s sarcoma is the most common malignancy in patients
with HIV infection. New studies point to the involvement of a
new human Kaposi s sarcoma herpes virus (KSHV) as a trans¬
forming agent. After transformation, cytokine perturbations facili¬
tate growth and in some cases clonal growth occurs. This results
in a malignancy with devastating clinical consequences. A clear
understanding of the mechanism of transformation by KSHV will
lead to better therapies.
HEMATOLOGY/ONCOLOGY CLINICS OF NORTH AMERICA
VOLUME 10 • NUMBER 5 • OCTOBER 1996 vii
Clinical Presentation and Natural History of
AIDS Related Kaposi s Sarcoma 1023
Bruce J. Dezube
Kaposi s sarcoma (KS) is the most common tumor arising in
persons infected with HIV, and among all HIV risk groups it is
most common in homosexual or bisexual men. During the past
decade KS has shifted more and more from being an index
diagnosis for AIDS to an opportunistic neoplasm occurring later
in the course of AIDS and leading to increasing morbidity and
mortality. This article focuses on the clinical presentation and
natural history of KS.
AIDS Related Kaposi s Sarcoma:
A Template for the Translation of Molecular
Pathogenesis into Targeted Therapeutic Approaches 1031
Judith E. Karp, James M. Pluda, and Robert Yarchoan
AIDS related Kaposi s sarcoma (KS) represents a complex interac¬
tion of host and viral factors. There are a number of fundamental
questions surrounding the interplay between the disparate factors
that can contribute to the pathogenesis and pathophysiology of
this disease. Targets such as the enhancement of immune func¬
tion, inhibition of angiogenic factors or immunostimulatory cy
tokines, inhibition of viral proteins such as Tat, or hormonal
manipulations are now or will in the future become the focus of
research to develop innovative anti KS therapy and prevention
measures. Antiviral approaches aimed at HIV or other viruses
may potentially target a number of steps in KS pathogenesis.
This article reviews diverse modalities—cytotoxic, antiviral, gene
directed, growth factor targeted, and antiangiogenesis—that sin¬
gly, or more likely in combination, stand to make an impact on
the cure and prevention of AIDS related KS.
Chemotherapy of AIDS Related Kaposi s Sarcoma 1051
Fa Chyi Lee and Ronald T. Mitsuyasu
Kaposi s sarcoma (KS) is the most common tumor associated
with AIDS. A growing number of patients with this tumor are
presenting at later stages of HIV with more rapidly progressive,
extensive, or symptomatic KS or with tumors involving visceral
organs. Chemotherapy treatment is effective in inducing tumor
regression, reducing edema, and ameliorating symptoms caused
by these tumors. Side effects and toxicities from these agents,
however, can be quite pronounced, especially in patients with
advanced AIDS. Antiretroviral therapy, prophylaxis for opportu¬
nistic infections, and the use of hematopoietic growth factors
should be routinely included in the management of these pa¬
tients. Newer chemotherapeutic agents and combination regi¬
mens may be more effective or less toxic than previously evalu¬
ated regimens.
viii contents
The Role of Radiation Therapy in the Management
of HIV Related Kaposi s Sarcoma 1069
Patrick S. Swift
Radiation provides excellent palliation for symptomatic Kaposi s
sarcoma in the settings of both limited and advanced disease.
Integration of radiotherapy into the overall treatment strategy is
critical to ensure that the benefits in terms of symptom reduction
are not outweighed by a long term increase in morbidity.
Etiology and Pathogenesis of AIDS Related
Non Hodgkin s Lymphoma 1081
Daniel M. Knowles
Non Hodgkin s lymphoma (NHL) is the second most common
neoplasm that occurs in HIV infected individuals. Possible factors
leading to the development of NHL include HIV induced immu
nosuppression, chronic antigenic stimulation, and cytokine over¬
production. NHL displays a variety of genetic alterations that
vary according to anatomic site of origination and histopathology,
suggesting that more than one pathogenic mechanism is opera¬
tional in the development and progression of NHL. AIDS related
NHL is an important biologic model for investigating the devel¬
opment and progression of high grade NHL as well as NHL that
develops in immune deficient hosts.
Diagnosis and Management of Systemic
Non Hodgkin s Lymphoma in HIV Disease 1111
Andrew S. Sandier and Lawrence D. Kaplan
Persons infected with HIV are at an increased risk for the devel¬
opment of intermediate and high grade non Hodgkin s lym¬
phoma (NHL). NHL occurs in the HIV setting in two major
groups: (1) those with systemic lymphoma and (2) those with
central nervous system disease. The clinical characteristics of
these groups are quite different. This article reviews both the
diagnosis and management of systemic non Hodgkin s lym¬
phoma in the HIV setting.
Biology and Management of AIDS Associated
Primary CNS Lymphomas 1125
Peter A. Forsyth and Lisa M. DeAngelis
Primary central nervous system (CNS) lymphoma is the most
common brain tumor in patients with AIDS and occurs in about
10% of this population. CT/MR scan usually demonstrates single
or multiple contrast enhancing masses that are radiographically
indistinguishable from other CNS processes such as toxoplasmo
sis. Brain biopsy, positive cerebrospinal fluid (CSF) cytology, or
possibly the demonstration of Epstein Barr viral DNA in the CSF
can establish the diagnosis. Cranial radiotherapy (RT) has been
CONTENTS IX
the cornerstone of therapy and produces responses in most pa¬
tients, but their median survival is still only a few months. The
addition of chemotherapy to RT may prolong survival in a sub¬
group of patients.
HIV Associated Hodgkin s Disease:
Biologic and Clinical Aspects 1135
Alexandra M. Levine
Increasing evidence suggests that the incidence of Hodgkin s
disease (HD) has increased in HIV infected individuals, with
intravenous drug users most likely to develop the disease. HIV
associated HD most often presents with disseminated, extra
nodal disease, with bone marrow involved in 40% to 50% of
cases. Mixed cellularity is the most common pathologic type of
disease, with Epstein Barr virus genome demonstrated in tumor
cell nuclei. Complete remission is attained in approximately 50%
of patients after combination chemotherapy, but median survival
is only in the range of 18 months.
Hematologic Disorders and Growth
Factor Support in HIV Infection 1149
David T. Scadden
During the course of HIV disease a broad spectrum of hemato¬
logic disorders develop including abnormalities in blood cell gen¬
eration, survival, and function. Alterations in coagulation param¬
eters may evolve associated with disruption of immunoglobulin
or factor production. This article reviews the manifestations and
pathophysiology of these abnormalities and discusses the role for
growth factor support.
Cervical Neoplasia: Pathogenesis, Diagnosis, and Management 1163
William R. Robinson and Cindy B. Morris
Cervical neoplasia is a common problem among HIV infected
women. HIV appears to accelerate human papillomavirus related
oncogenic events via incompletely understood mechanisms. Cyto
logic screening for cervical neoplasia appears to be unreliable in
HIV infected women. Treatment is also not very effective. Inva¬
sive cervical cancer in particular has a very poor prognosis. Inno¬
vative therapeutic modalities are currently being investigated.
Anal Neoplasia: Pathogenesis, Diagnosis, and Management 1177
Donald W. Northfelt, Patrick S. Swift, and Joel M. Palefsky
Numerous observations have suggested that human immunode¬
ficiency virus (HlV) induced immunodeficiency may be associ¬
ated with the development of neoplasia of the cervical and anal
mucosa. Anal intraepithelial neoplasia (AIN) and human papillo
mavirus infections are more common and severe in HIV infected
X CONTENTS
men than in non HIV infected persons with similar demographic
characteristics. The natural history and appropriate management
of AIN has not been fully elucidated but this condition should
probably be viewed as a precursor of invasive cancer and treated
with strategies similar to those used for analogous disease of the
uterine cervix. Anecdotal observations suggest that anal cancer
in HIV infected persons may be more difficult to treat success¬
fully than anal cancer in the non HIV infected but standard treat¬
ment strategies have been employed successfully.
Cancers In Children With HIV Infection 1189
Kenneth L. McClain, Vijay V. Joshi, and Sharon B. Murphy
Although malignancies in children with AIDS have not reached
the rate found in adults, careful observation of all patients, espe¬
cially those on anti retroviral therapy, is prudent. Non Hodgkin s
lymphomas are the most frequent malignancies of these children
and are curable with standard chemotherapy regimens. Leiomyo
mas and leiomyosarcomas are the second most frequent cancers
in these children. True Kaposi s sarcoma is probably less common
in children with HIV infection than was once thought. Some
atypical lymphoproliferations of these children may be classified
into a new category—mucosa associated lymphoid tissue
(MALT) tumors.
Non AIDS Defining Cancers 1203
Scot C. Remick
As the HIV epidemic advances, the spectrum of non AIDS defin
ing malignancy is expanding. Recent reports suggest an increased
incidence of basal cell carcinoma of skin, squamous cell carci¬
noma of the anus, Hodgkin s disease, and seminoma in HIV
infected patients. Other solid tumors also encountered in this
setting include other skin cancers, oral mucosa and head and
neck carcinoma, lung cancer, and testicular neoplasms. The clini¬
cal features and natural history of these neoplasms are reviewed
and compared with those in patients who are HIV seronegative/
indeterminate.
Index 1215
Subscription Information Inside back cover
CONTENTS i
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| spellingShingle | Hematologic and oncologic aspects of HIV infection Hematology, oncology clinics of North America Krebs Medizin (DE-588)4073781-0 gnd HIV-Infektion (DE-588)4203852-2 gnd Aids (DE-588)4112470-4 gnd |
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| title | Hematologic and oncologic aspects of HIV infection |
| title_auth | Hematologic and oncologic aspects of HIV infection |
| title_exact_search | Hematologic and oncologic aspects of HIV infection |
| title_full | Hematologic and oncologic aspects of HIV infection Susan E. Krown ... guest ed. |
| title_fullStr | Hematologic and oncologic aspects of HIV infection Susan E. Krown ... guest ed. |
| title_full_unstemmed | Hematologic and oncologic aspects of HIV infection Susan E. Krown ... guest ed. |
| title_short | Hematologic and oncologic aspects of HIV infection |
| title_sort | hematologic and oncologic aspects of hiv infection |
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