HIV-RELATED MALIGNANCIES (MEETING ABSTRACT)

Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.

HIV-RELATED MALIGNANCIES (MEETING ABSTRACT)

Proc Annu Meet Am Assoc Cancer Res; 33:A590-1 1992. Unique Identifier : AIDSLINE ICDB/92687929
Levine AM; Div. of Hematology, Univ. of Southern California Sch. of; Medicine, Los Angeles, CA 90033

Abstract: Organ transplantation, with subsequent iatrogenic immunosuppression and chronic antigenic stimulation may be seen as a model by which to begin the study of AIDS-related malignancies. Thus, patients (pts) who have undergone allogeneic transplantation are at increased risk for certain tumors, including Kaposi's sarcoma (KS), malignant lymphoma, squamous cell carcinomas of skin, of uterine cervix, and of anus and vulva. The time course to development of these malignancies has been similar to that observed in HIV-infected pts who have subsequently developed neoplastic disease. Thus, the latent period between transplantation and KS is approx 20 mo, while that of lymphoma is 33 mo, and that of squamous cell carcinomas of anus or cervix is approx 100 mo. The first malignancy described in AIDS was Kaposi's sarcoma, noted at the outset of the epidemic, in 1981; incidence of lymphoma was not shown to have increased significantly until 1985. While squamous cell carcinomas of the uterine cervix or anus have not yet increased significantly in epidemiologic terms, these neoplasms are clearly being diagnosed with greater frequency as HIV-infected pts live long enough to develop these particular cancers. KS is seen almost exclusively in homosexual or bisexual men, in whom the incidence is approx 20%. By contrast, KS has been diagnosed in only 1-3% of transfusion recipients or hemophiliacs with AIDS and is quite unusual in HIV-infected women, in whom the risk for AIDS has primarily been sexual contact with a bisexual man. These data, as well as the recent description of young homosexual men with KS but without HIV infection, has led some investigators to speculate that KS may be related to the presence of another, as yet unidentified sexually transmitted agent, which might have entered the homosexual population at approx the same time as HIV. The pathogenesis and clinical experience of AIDS-related KS are summarized. Lymphoma is a relatively late manifestation of HIV infection, expected with increasing frequency as HIV-infected pts live longer. All groups at risk for HIV infection are also at risk for lymphoma. AIDS-related lymphomas are high-grade, B-cell tumors, including B-immunoblastic or small noncleaved lymphoma, which comprise approx 75-90% of cases. Intermediate grade large cell lymphomas may also be seen. Clinical characteristics and experience of AIDS-related lymphoma are summarized. Pathogenesis of the disease has not yet been fully elucidated, but may require multiple steps, including chronic B-cell proliferation induced by cytokine release from HIV-infected T cells and macrophages or by EBV; immune dysregulation induced by HIV; chronic antigenic stimulation; accumulation of mutations in critical oncogenes or tumor suppressor genes; abnormal DNA rearrangements (recombinase errors) of B lymphocytes, leading to chromosomal translocations (t8;14, t8;22, t8;2); subsequent c-myc dysregulation; clonal selection; and development of lymphoma. (10 Refs)

Keywords: Antineoplastic Agents, Combined/THERAPEUTIC USE Bleomycin/THERAPEUTIC USE Cell Division Cytokines/METABOLISM CD4-Positive T-Lymphocytes/CYTOLOGY Doxorubicin/THERAPEUTIC USE Herpesvirus 4, Human Homosexuality Human HIV Infections/*COMPLICATIONS/DRUG THERAPY/IMMUNOLOGY/PATHOLOGY/ TRANSMISSION Leukocyte Count Lymphoma, AIDS-Related/IMMUNOLOGY/*PATHOLOGY Male Sarcoma, Kaposi's/DRUG THERAPY/*ETIOLOGY/IMMUNOLOGY/METABOLISM/ PATHOLOGY Vincristine/THERAPEUTIC USE Zidovudine/THERAPEUTIC USE ABSTRACT
921230
M92C5363

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 1992. 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, 1992. 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. .