Important note: Information in this article was accurate in 1986. The state of the art may have changed since the publication date.
CANCER IN THE IMMUNOSUPPRESSED HOST
Cancer - Principles and Practice of Oncology. 2nd Edition. DeVita VT Jr, Hellman S, Rosenberg SA, eds. Philadelphia, Lippincott, p. 1999-2006, 1985.. Unique Identifier : AIDSLINE ICDB/86620355 Blattner WA; Hoover RN; Family Studies Section, Environmental Epidemiology Branch, Div.; of Cancer Etiology, NCI, Bethesda, MD
Abstract:
Congenital immune deficiency, drug-induced immunodeficiency, clinical conditions associated with altered immunity, and acquired immunodeficiency syndrome (AIDS) are each reviewed with respect to development of malignancies. Fourteen naturally occurring, genetically determined immunodeficiency diseases have been defined and associated with malignancy; 7 (severe combined immunodeficiency, DiGeorge's syndrome, ataxia telangiectasia, infantile sex-linked hypogammaglobulinemia, Wiskott-Aldrich syndrome, common variable immunodeficiency, and x-linked lymphoproliferative syndrome) account for the bulk of such immunodeficiency-associated malignancies. The most common cause of death for all these syndromes is overwhelming infection with opportunistic agents. The best quantified association between immune alteration and human carcinogenesis is found in persons who have been observed to have substantially increased risks of developing non-Hodgkin's lymphoma following kidney transplantation and treatment with large doses of immunosuppressive agents to prevent rejection; transplant recipients also have an excessive incidence of squamous cell cancer of the skin. Many more people have their immune systems altered by a variety of clinical conditions than by genetic or drug factors. Some of the disorders with secondary immunologic defects have been associated with excessive incidence of non-Hodgkin's lymphoma (eg, 3-4-fold risk in patients with celiac disease and 40-fold risk in pts with sicca syndrome). The most consistent immunologic abnormality in AIDS is profound lymphopenia, particularly involving T-lymphocytes that bear the helper/inducer phenotype defined by the monoclonal antibodies OKT-4 and Leu-3. The transmissible agent is responsible for AIDS-associated immunoablation is designated HTLV-III, a cytopathic member of a newly discovered family of human lymphotropic retroviruses that were previously shown to be most strongly linked to a form of aggressive, mature T-cell leukemia termed adult T-cell leukemia/lymphoma. Cancers associated with AIDS include Kaposi's sarcoma, squamous cell cancer of the oropharynx, cloacogenic carcinoma of the anus, and Burkitt's lymphoma. (81 Refs)
Keywords: Acquired Immunodeficiency Syndrome/COMPLICATIONS/ETIOLOGY Adult Child Child, Preschool Female Human HTLV-BLV Viruses Immunologic Deficiency Syndromes/*COMPLICATIONS/ETIOLOGY Immunosuppressive Agents/ADVERSE EFFECTS Kidney/TRANSPLANTATION Kidney Transplantation Male Neoplasms/*ETIOLOGY *Retroviridae Infections MONOGRAPH
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Important note: Information in this article was accurate in 1986. The state of the art may have changed since the publication date.
