1
|
Yotsumoto M, Hagiwara S, Ajisawa A, Tanuma J, Uehira T, Nagai H, Fujikawa Y, Maeda S, Kitano K, Arima N, Uno K, Iwai T, Hongo I, Ota Y, Fukutake K, Okada S. Clinical characteristics of human immunodeficiency virus-associated Hodgkin lymphoma patients in Japan. Int J Hematol 2012; 96:247-53. [DOI: 10.1007/s12185-012-1127-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Revised: 05/28/2012] [Accepted: 06/06/2012] [Indexed: 12/14/2022]
|
2
|
Martí-Carvajal AJ, Cardona AF, Lawrence A. Interventions for previously untreated patients with AIDS-associated non-Hodgkin's lymphoma. Cochrane Database Syst Rev 2009:CD005419. [PMID: 19588373 DOI: 10.1002/14651858.cd005419.pub2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Human immunodeficiency virus (HIV) infection is known to be associated with an increased risk of non-Hodgkin's lymphoma (NHL). The majority of lymphomas (>80%) occurring during immunosuppression are aggressive B-cell in origin and have a high-to-intermediate histology grade. Treatment of NHL is not standardized. OBJECTIVES To assess the clinical effectiveness and safety of single agent or combination chemotherapy with or without immunochemotherapy (rituximab) and with or without highly active antiretroviral therapy (HAART) on overall survival (OS) and disease-free survival (DFS) for previously untreated patients with AIDS-related NHL. SEARCH STRATEGY The Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 1, 2009), MEDLINE (1966-March 6, 2009), EMBASE (1988-March 6, 2009), LlLACS (1982 to February 17, 2009), Gateway (March 6, 2009), and AIDSearch (2006 -February 2008) were used to identify published, potentially eligible trials. Further, we searched several electronic sources. For additional information see the Cochrane HIV/AIDS Group search strategy. SELECTION CRITERIA Randomized controlled trials (RCTs) assessing the effectiveness of systemic treatments for previously untreated AIDS-related NHL. There were no age or language restrictions. DATA COLLECTION AND ANALYSIS Authors independently assessed relevant studies for inclusion; four RCTs were selected. No meta-analysis was attempted due to clinical heterogeneity. MAIN RESULTS Four RCTs that included 857 patients (number range: 30 to 485) met the inclusion criteria. The studies have a high risk of bias; three RCTs were conducted in the United States and one was a multi-national, multi-centre RCT performed in France and Italy. One of the trials included only men. It was impossible to pool data for any of the outcomes due to the differences in the interventions assessed in these RCTs. Overall survival did not differ significantly between treatment groups. Disease free survival (DFS) was reported in two of the four RCTs, but it was not statistically significant between treatment groups. AUTHORS' CONCLUSIONS We found no evidence that the systemic interventions for untreated patients with AIDS-related NHL provide superior clinical effectiveness for improving OS, DSF, and tumour response rate; however, this conclusion is based on four RCTs with limited sample size and variable quality. More adequately powered RCTs that have low risk of bias are necessary to determine the real benefit or harm of interventions to treat this population. Overall survival (OS), DFS, and quality of life should be included as endpoints.
Collapse
|
3
|
Miralles P, Berenguer J, Ribera Santasusana JM, Calvo F, Díaz Mediavilla J, Díez-Martín JL, Gomez Codina J, López Aldeguer J, Rubio R, Santos J, Valencia E. Recomendaciones de GESIDA/PETHEMA sobre el diagnóstico y el tratamiento de los linfomas en pacientes infectados por el virus de la inmunodeficiencia humana. Med Clin (Barc) 2008; 130:300-11. [PMID: 18358123 DOI: 10.1157/13116574] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Pilar Miralles
- Servicio de Enfermedades Infecciosas/VIH, Hospital General Gregorio Marañón, Madrid, España.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Martí-Carvajal AJ, Munoz SR. Interventions for treating AIDS-associated Non-Hodgkin´s Lymphoma (NHL) in treatment-naive adults with AIDS. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2005. [DOI: 10.1002/14651858.cd005419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
5
|
Powles T, Bower M, Shamash J, Stebbing J, Ong J, Daugaard G, De Ruiter A, Johnson M, Fisher M, Anderson J, Nelson M, Gazzard B, Oliver T. Outcome of patients with HIV-related germ cell tumours: a case-control study. Br J Cancer 2004; 90:1526-30. [PMID: 15083180 PMCID: PMC2409707 DOI: 10.1038/sj.bjc.6601762] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Testicular germ cell tumour (GCT) is not an AIDS-defining illness despite an increased incidence in men with HIV infection. We performed a matched case-control study comparing outcomes in HIV-positive men and the general population with GCT, using three age and stage matched controls for each case. There was no difference in the 5-year GCT-free survival between cases and controls. However, overall survival was significantly decreased in the cases (log rank P=0.03). HIV was responsible for 70% of this mortality. The relapse-free survival for stage I patients treated with orchidectomy and surveillance was not affected by HIV status (log rank P=0.68). There was no difference in disease free survival in patients with metastatic disease (log rank P=0.78). The overall survival has not improved since the introduction of highly active antiretroviral therapy (log rank P=0.4). Thus, HIV-related GCT is not more aggressive than GCT in the general population.
Collapse
Affiliation(s)
- T Powles
- Department of Oncology, Chelsea and Westminster Hospital, Fulham Road, London SW10 9NH, UK
- Department of HIV Medicine, Chelsea and Westminster Hospital, London, UK
| | - M Bower
- Department of Oncology, Chelsea and Westminster Hospital, Fulham Road, London SW10 9NH, UK
- Department of HIV Medicine, Chelsea and Westminster Hospital, London, UK
- Department of Oncology, Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK.
E-mail:
| | - J Shamash
- St Bartholomew's & Royal London Hospital, London, UK
| | - J Stebbing
- Department of Oncology, Chelsea and Westminster Hospital, Fulham Road, London SW10 9NH, UK
- Department of HIV Medicine, Chelsea and Westminster Hospital, London, UK
| | - J Ong
- St Bartholomew's & Royal London Hospital, London, UK
| | | | | | | | - M Fisher
- Royal Sussex County Hospital, Brighton, UK
| | - J Anderson
- St Bartholomew's & Royal London Hospital, London, UK
| | - M Nelson
- Department of Oncology, Chelsea and Westminster Hospital, Fulham Road, London SW10 9NH, UK
- Department of HIV Medicine, Chelsea and Westminster Hospital, London, UK
| | - B Gazzard
- Department of Oncology, Chelsea and Westminster Hospital, Fulham Road, London SW10 9NH, UK
- Department of HIV Medicine, Chelsea and Westminster Hospital, London, UK
| | - T Oliver
- St Bartholomew's & Royal London Hospital, London, UK
| |
Collapse
|
6
|
Peña Avila M, Cogolludo Pérez FJ, Silva Grosso M, Santos Corchero JM, Téllez Molina MJ, Martín Rodilla MC, Poch Broto J. [Report of a case: non-Hodgkin's lymphoma of the hypopharynx in a patient with HIV infection. Remission without lymphoma-specific treatment]. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2004; 54:597-600. [PMID: 14755922 DOI: 10.1016/s0001-6519(03)78455-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Non-Hodgkin's lymphomas (NHL) are common in HIV patients, although it is rare for primary lymphomas to develop in the larynx or hypopharynx. We present the case of a patient that was diagnosed of a high degree NHL, following a biopsy of the piriform sinus' lesion, taker by direct laryngoscopy. Simultaneously he was diagnosed as HIV. The interest of this paper is the total remission of the lymphoma seen after specific HIV treatment only.
Collapse
Affiliation(s)
- M Peña Avila
- Servicio ORL, Patológica, Hospital Clínico San Carlos, Madrid
| | | | | | | | | | | | | |
Collapse
|
7
|
Molina A, Zaia J, Krishnan A. Treatment of human immunodeficiency virus-related lymphoma with haematopoietic stem cell transplantation. Blood Rev 2003; 17:249-58. [PMID: 14556780 DOI: 10.1016/s0268-960x(03)00026-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The advent of highly active antiretroviral therapy (HAART) and its co-administration with chemotherapy in patients with human immunodeficiency virus (HIV)-related lymphoma has lead to the exploration of potentially curative combination chemotherapy and myeloablative therapy followed by autologous haematopoietic stem cell transplantation (ASCT). Applying the same principles used for patients with HIV-negative aggressive lymphoma, in 1998 we developed a program of high-dose therapy and ASCT at City of Hope for patients with HIV-related lymphoma and Hodgkin's disease. Our studies have primarily included patients with chemosensitive lymphoma in relapse or first remission with poor-risk features at diagnosis. Filgrastim (G-CSF)-primed peripheral blood stem cell mobilization and apheresis have been successful while patients were receiving HAART and chemotherapy. To date, ASCT has been performed in 19 patients with HIV-related lymphoid malignancies, representing the largest single-institution experience reported to date. Most patients received a chemotherapy-based conditioning regimen consisting of high-dose carmustine, etoposide and cyclophosphamide. Early infections, namely bacteremias and neutropenic fever were similar to those observed in the HIV-negative transplant setting. Opportunistic infections were rare and easily treatable. There were three early deaths, two from relapsed lymphoma and one from multi-organ failure in an older patient. The remaining 16 patients are alive and in remission. In summary, ASCT is well tolerated, can result in long-term remissions, and is potentially curative in selected HIV-related lymphoma patients with chemosensitive relapse and high-risk disease in first remission defined by the age-adjusted International Prognostic Index criteria (i.e., two or three of the following: elevated LDH, advanced stage, and poor performance status). Acquisition of resistance to HAART remains as a potential problem for HIV-positive patients who are cured of their lymphoma.
Collapse
Affiliation(s)
- Arturo Molina
- Division of Hematology and Bone Marrow Transplantation and Department of Virology, City of Hope National Medical Center, Duarte, CA, USA.
| | | | | |
Collapse
|
8
|
Berretta M, Cinelli R, Martellotta F, Spina M, Vaccher E, Tirelli U. Therapeutic approaches to AIDS-related malignancies. Oncogene 2003; 22:6646-59. [PMID: 14528290 DOI: 10.1038/sj.onc.1206771] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The introduction of highly active antiretroviral therapy (HAART) has changed dramatically the landscape of HIV disease. Deaths from AIDS-related diseases have been reduced by 75% since protease inhibitor therapy and combination antiretroviral therapy came into use in late 1995. While KS is declining, the situation for non-Hodgkin's lymphoma is more complex with a reduced incidence of primary central nervous system lymphoma, but a relatively stability in the number of patients developing systemic NHL. AIDS related NHL appears not to be markedly decreased by the introduction of HAART and it is the greatest therapeutic challenge in the area of AIDS oncology. The emphasis has now shifted to cure while maintaining vigilance regarding the unique vulnerability of HIV-infected hosts. Furthermore, also for the prolongation of the survival expectancy of these patients, other non AIDS-defining tumors, such as Hodgkin's disease, anal and head and neck, lung and testicular cancer, and melanoma have been recently reported with increased frequency in patients with HIV infection.
Collapse
Affiliation(s)
- Massimiliano Berretta
- Division of Medical Oncology A, Centro di Riferimento Oncologico, National Cancer Institute, Via Pedemontana Occ.Le 12, Aviano (PN) 33081, Italy
| | | | | | | | | | | |
Collapse
|
9
|
Hoffmann C, Wolf E, Fätkenheuer G, Buhk T, Stoehr A, Plettenberg A, Stellbrink HJ, Jaeger H, Siebert U, Horst HA. Response to highly active antiretroviral therapy strongly predicts outcome in patients with AIDS-related lymphoma. AIDS 2003; 17:1521-9. [PMID: 12824790 DOI: 10.1097/00002030-200307040-00013] [Citation(s) in RCA: 92] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND AIDS-related lymphoma (ARL) remains a frequent complication of HIV infection. We analyzed the outcome of patients with ARL with respect to the use and efficacy of highly active antiretroviral therapy (HAART) and to potential prognostic factors. METHODS This multicenter cohort study included patients with systemic ARL diagnosed between 1990-2001. We evaluated overall survival and the effects of several variables on overall survival using the Kaplan-Meier method and the extended Cox proportional hazards model. Response to HAART was used as a time-dependent variable and was defined as a CD4 cell count increase of >/= 100 x 106 cells/l and/or at least one viral load < 500 copies/ml during the first 2 years following diagnosis of ARL. RESULTS Among 203 patients with ARL, median overall survival was 9.0 months [95% confidence interval (CI), 7.6-12.4 months]. In the univariate analyses, age < 60 years, no previous AIDS, CD4 cell counts >/= 200 x 106 cells/l, hemoglobin > 11 g/dl, Ann Arbor stages I-II and A, no extranodal lesion, response to HAART, and complete remission showed statistically significant association with prolonged overall survival. In the multivariate Cox model, the only factors independently associated with overall survival were response to HAART [relative hazard (RH), 0.32; 95% CI, 0.16-0.62], complete remission (RH, 0.24; 95% CI, 0.15-0.36), previous AIDS (RH, 1.92; 95%CI, 1.23-3.01) and extranodal involvement (RH, 2.85; 95% CI, 1.47-5.51). CONCLUSIONS Efficacy of HAART was independently associated with prolonged survival in this large cohort of patients with ARL. Information on patient's response to HAART is crucial for the evaluation of future treatment strategies.
Collapse
|
10
|
Abstract
Immunodeficiency alters the risk of cancer. Specific types of immune dysfunction are associated with different tumor risks, but most tumors are related to oncogenic viruses. In acquired immunodeficiency due to the human immunodeficiency virus (HIV), HIV itself rarely directly causes cancer; rather, it provides the immunologic background against which other viruses can escape immune control and induce tumors. The most common malignancies are Kaposi's sarcoma and non-Hodgkin's lymphoma. This chapter discusses the pathophysiologic background of these tumors, how they have been affected by the use of anti-HIV medications, and their clinical management.
Collapse
Affiliation(s)
- David T Scadden
- AIDS Research Center and Cancer Center, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, Room 5212, Boston, Massachussetts 02129, USA.
| |
Collapse
|
11
|
Gastaldi R, Martino P, Gentile G, Picardi V, De Propris MS, Pirillo MF, De Vellis A, Mandelli F. Hodgkin's disease in HIV-infected patients: report of eight cases usefully treated with doxorubicin, bleomycin, vinblastine and dacarbazine (ABVD) plus granulocyte colony- stimulating factor. Ann Oncol 2002; 13:1158-60. [PMID: 12176798 DOI: 10.1093/annonc/mdf239] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
12
|
Tirelli U, Bernardi D, Spina M, Vaccher E. AIDS-related tumors: integrating antiviral and anticancer therapy. Crit Rev Oncol Hematol 2002; 41:299-315. [PMID: 11880206 DOI: 10.1016/s1040-8428(01)00165-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The introduction of highly active antiretroviral therapy (HAART) has changed dramatically the landscape of HIV disease. Deaths from AIDS-related diseases have been reduced by 75% since protease inhibitor therapy and combination antiretroviral therapy came into use in late 1995. While KS is declining, the situation for non-Hodgkin's lymphoma is more complex with a reduced incidence of primary central nervous system lymphoma, but a relative stability in the number of patients developing systemic NHL. AIDS-related NHL appears not to be markedly decreased by the introduction of HAART and it is the greatest therapeutic challenge in the area of AIDS oncology. The emphasis has now shifted to cure while maintaining vigilance regarding the unique vulnerability of HIV-infected hosts. Furthermore, also for the prolongation of the survival expectancy of these patients, other non-AIDS-defining tumors, such as Hodgkin's disease, anal, head and neck, lung and testicular cancer, and melanoma have been recently reported with increased frequency in patients with HIV infection.
Collapse
Affiliation(s)
- Umberto Tirelli
- Division of Medical Oncology A, National Cancer Institute, Via Pedemontana Occ. Le 12, Aviano (PN) 33081, Italy.
| | | | | | | |
Collapse
|
13
|
Miralles P, Rubio C, Berenguer J, Ribera JM, Calvo F, Diaz Mediavilla J, Diez-Martín JL, López Aldeguer J, Valencia E, Rubio R, Felipe C. [GESIDA/PETHEMA guidelines for the diagnosis and treatment of lymphomas in HIV-infected patients]. Med Clin (Barc) 2002; 118:225-36. [PMID: 11864547 DOI: 10.1016/s0025-7753(02)72342-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Pilar Miralles
- Hospital General Gregorio Marañón, Madrid, Spain. pmiralles@eresmas-net
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|