AIDS AND CANCER

Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.

AIDS AND CANCER

Current Therapy in Hematology-Oncology-3. Brain MC, Carbone PP, eds. Current Therapy Series, Toronto, B.C. Decker, p. 350-2, 1988.. Unique Identifier : AIDSLINE ICDB/89657395
Ziegler JL; AIDS Clinical Research Center, San Francisco, CA

Abstract: In 1981, the unusual occurrence of Kaposi's sarcoma (KS) and opportunistic infections in homosexual men heralded the epidemic of AIDS. AIDS-induced alterations in the natural history of cancer, treatment strategies for KS, non-Hodgkin's lymphoma (NHL) and other cancers in patients (pts) with AIDS; and the role of prophylactic antibiotics in AIDS management are discussed. Pts from AIDS epicenters who received blood transfusions prior to 1985 may have been exposed to HIV. Such pts who become immune compromised by cancer therapy are at risk of developing symptomatic illness. Thus, the development of unusual infections in previously transfused cancer pts undergoing immunosuppressive therapy should raise the clinical suspicion of AIDS. Radiation therapy is the treatment of choice for management of localized, cosmetically troublesome, or symptomatic KS lesions. Aggressive combination chemotherapy regimens employing Adriamycin, bleomycin, and vinblastine achieve response rates around 80%, but with formidable toxicity. The objective of treatment of epidemic KS is palliation without inducing further immune suppression. Pts with AIDS-associated NHL tolerate therapy rather poorly. Chemotherapy regimens have been modified with the following objectives: (1) minimal myelosuppression and immunosuppression; (2) outpatient management; (3) CNS prophylaxis; and (4) the rise of synergistic, alternating, non-cross-resistant regimens. For other cancers in pts with AIDS, the author manages local tumors with radiotherapy where possible. When chemotherapy is indicated (eg, Hodgkin's disease, anal cancer, small cell carcinoma, or acute leukemia), chemotherapy regimens should be tailored to minimize myelosuppression. The use of prophylactic antibiotics in pts with AIDS is controversial. Antiretroviral agents, such as azidothymidine and ribavirin, are being used increasingly in pts with AIDS and AIDS-related complex, respectively. Both agents are myelosuppressive and will undoubtedly compromise doses and schedules of cancer chemotherapy.

Keywords: Acquired Immunodeficiency Syndrome/*COMPLICATIONS Combined Modality Therapy Human Lymphoma, Non-Hodgkin's/*THERAPY Prognosis Risk Factors Sarcoma, Kaposi's/*THERAPY Skin Neoplasms/*THERAPY JOURNAL ARTICLE
891230
M89C0825

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from Boehringer Ingelheim, Bridgestone/Firestone Charitable Trust, Bristol-Myers Squibb Company, Elton John AIDS Foundation, Gill Foundation, the National Library of Medicine, Quest Diagnostics, Roche and Trimeris, and donations from users like you. Always watch for outdated information. This article first appeared in 1989. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 1989. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .