[AIDS-related malignancy].
Although Kaposi's sarcoma (KS) has been considered a rare disease, the disease is well known at present since the onset of AIDS in 1981. The characteristics of AIDS-associated KS are a multifocal, widespread distribution that may involve lymph node, gastrointestinal tract, and visceral organs. KS may be the first sign of HIV-infection, but it can also arise in some patients who lack evidences of immune impairment. The more effective chemotherapy of AIDS-associated KS is low-dose-ABV-combination (adriamycin, bleomycin and vincristine) and its response rate is about 80%-90%. The second cancer that occurred in the AIDS-related immune impairement is malignant lymphoma. Approximately 90% of AIDS-related malignant lymphoma reported have been of high grade, B-cell types, including B immunoblastic type and small non-cleaved cell lymphoma. They have another distinguishing feature that is wide spread extent of disease at presentation, with extranodal involvement recorded in 80% to 90% of all patients. The most common sites of involvement are CNS (central nervous system) (32%), gastrointestinal tract (26%), bone marrow (25%) and liver (12%). It was reported that the median CE4 count in patients with primary-CNS lymphoma was 37 cells/dl, versus 189 cells/dl in those with systemic disease. It is important to note that approximately 17% of leptomeningeal disease is asymptomatic. The recommended treatment of AIDS-associated lymphoma by Levine is a low-dose modification of the M-BACOD (bleomycin, doxorubicin, cyclophosphamide, vincristine, dexamethasone, cytosine arabinoside, azidothymidine and helmet field radiotherapy). A complete remission (CR) rate of 46% was achieved. The median survival time of CR patients was 15 months.(ABSTRACT TRUNCATED AT 250 WORDS)
Sakurada
K
K
Third Department of Internal Medicine, Hokkaido University School of Medicine, Sapporo, Japan.
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D006801:Humans; D016483:Lymphoma, AIDS-Related / Q000628:therapy*; D012514:Sarcoma, Kaposi / Q000209:etiology / Q000628:therapy*