Aggressive lymphomas, a general term that includes any cancer that infects the lymph system, can occur among patients who are HIV-positive. It is estimated that 10 percent of HIV-positive patients will develop lymphoma. The lymphomas that are most often seen in HIV patients who develop them are large cell immunoblastic; small non-cleaved cell (Burkitt's and Non-Burkitt's); primary central nervous system (CNS); and Hodgkin's disease.
Large cell immunoblastic lymphoma is an aggressive type of lymphoma that grows rapidly and may involve the brain, bone, skin or gastrointestinal tract. Small non-cleaved cell lymphoma (SNCL) is also an aggressive form that comes in three varieties, all of which are more prevalent in males. Burkitt's includes endemic (widespread) Burkitt's lymphoma; sporadic Burkitt's lymphoma; and non-Burkitt's lymphoma.
Primary central nervous system (CNS) lymphoma is lymphoma limited to the brain and brain stem without widespread disease. An increasing incidence of this disease has been seen among AIDS patients and other individuals with compromised immune systems. Hodgkin's disease or Hodgkin's lymphoma is a malignant (cancerous) growth of cells in the lymph system.
The symptoms, staging and methods of diagnosing Hodgkins's disease are the same for both the AIDS and non-AIDS related forms. Likewise, treatment may include radiation therapy, chemotherapy and bone marrow and blood stem cell transplants. Scientists, however, are looking for new drugs that specifically target people with AIDS-related lymphomas.
Research into the effectiveness of immunotherapy and into monoclonal antibodies is also underway. Monoclonal antibodies can locate cancer cells and either eliminate them or deliver cancer-killing substances to them without harming normal cells.
Human Papilloma Virus Anogenital Cancers
HIV-infected patients can develop squamous intraepithelial lesions of the uterine cervix (in women) and squamous cell carcinoma of the anus (in men). Associated with infection by oncogenic papilloma-virus, these tumors do not respond to available HIV therapy. Early detection by frequent examination of women using PAP smears and colposcopic evaluations are important strategies for early diagnosis and treatment.
Men at risk are considered candidates for proctologic evaluations as well as for PAP smears of the anus and anal canal. Contained tumors receive local treatment while invasive and/or advanced cases are treated with a combination of local and systemic approaches.
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