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PubMed1992

Linkage of death certification of AIDS and cancer registration in Vaud, Switzerland.

58 death certifications (40 males and 18 females) of residents of the Canton of Vaud (Switzerland) which reported AIDS as the cause of death in 1986-1989 were matched with the list of incident cancers available since 1974 from the Vaud Cancer Registry. Such linkage was successful for 20 individuals (age range 25-63, median 37), mostly males (18/20), homosexual or bisexual (11/18) and affected by Kaposi's sarcoma (14 males and 1 female). Other identified neoplasms included one Burkitt's lymphoma, one prostate adenocarcinoma and one multiple myeloma (whose histological picture included, however, lymphocytosis in addition to plasmocytosis). Three additional malignancies (one undifferentiated skin cancer, one carcinoma of the salivary glands and one in situ cervical carcinoma), and one myelodysplastic syndrome had also been diagnosed from 1 to 2 years before AIDS death. Cancer was mentioned on the death certificate, in addition to AIDS, in only 2 cases. Albeit of limited size, the present report confirms that a systematic integration of AIDS and cancer registration statistics provides additional information, of particular interest for histological classification, on the AIDS-cancer relationship.

Acquired Immunodeficiency Syndrome↗
PubMed2006

[Inflammatory reconstitution immune syndrome associated to antiretroviral therapy and meningeal cryptococcosis].

The objective of high activity antiretroviral therapy (HAART) in patients with AIDS, is to obtain immune restoration. This means a reduction of the viral load and restitution of the CD4 cell count. A decreased rate of HIV replication improves both the number and function of CD4 cells. Nevertheless, this treatment sometimes results in the reappearance of previous symptoms from treated conditions due to opportunistic infections (ie: tuberculosis, criptococcosis, hepatitis, Pneumocystis jirovesi, toxoplasmosis, etc) or non infectious condition such as sarcoidosis, Graves disease or Kaposi sarcoma. This is known as Inflammatory Reconstitution Immune Syndrome (IRIS). We report a 37 year-old woman in stage C3-AIDS with a previous criptococcal meningitis. She was treated, achieving a marked improvement with treatment and subsequent suppressive therapy with fluconazole 200 mg/day. IRIS appeared after 8 months of ongoing antiretroviral therapy with immune restoration with the development of aseptic meningitis and intracranial hypertension. The opportunistic agent could not be identified by cultures. Additional laboratory tests excluded toxoplasmosis, tuberculosis, bacterial cerebral abscesses, syphilitic cerebral gummas, and lymphoma. Brain CT and magnetic resonance studies were compatible with brain vasculitis and leptomeningitis. The patient condition improved with general measures, such as a repeated lumbar punctures and non steroidal anti-inflammatory drugs. We conclude that this patient had an IRIS due to a Cryptococcus neoformans antigen.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

[Methodological issues and first results of a record linkage between AIDS and Cancer Registries in Italy].

We report herein, the first results of a record linkage between the Italian AIDS Registry and 13 population-based Cancer Registries (about 8-million population in 1991). An anonymous linkage process was carried out on about 339,000 cancer notifications and 6,067 AIDS ones reported between 1982 and 1994. Out of 243 Kaposi's sarcomas (KS) below age 50 years recorded at either type of registry, 90 (37%) were reported as such by both. Sixty-eight percent of individuals with KS at Cancer Registries could be identified at the AIDS Registry. Sixty-two percent of individuals with KS and 65% of individuals reported as having non-Hodgkin's lymphoma (NHL) at RAIDS could be also found at Cancer Registries. Among 6,067 persons with AIDS 15-69 years old, observed and expected numbers of cancer and age-standardised incidence ratios (SIR) on a total of 25,759 person-years were computed. Significantly increased SIR was found for Hodgkin's disease (8.9; 95% CI: 4.4-16.0), invasive carcinoma of the cervix uteri (15.5; 95% CI: 4.0-40.1), and non-melanomatous skin cancer (3.0, 95%, CI: 1.3-5.9). As in previous studies, KS and NHL were greatly increased (SIR = 1,300 and 59, respectively). The risk for all cancer types, after exclusion of KS and NHL, was approximately twice the risk of the general population. An increased SIR of Hodgkin's disease in persons with AIDS is thus confirmed, though many-fold smaller than for NHL. An association with invasive carcinoma of the cervix is also shown at a population level. These data indicate the potential of AIDS and Cancer Registries for improving cancer assessment in individuals with HIV/AIDS and elucidating the role of immune system on cancer onset.

Acquired Immunodeficiency Syndrome↗
PubMed1986

A murine monoclonal antibody detecting N-acetyl- and N-glycolyl-GM2: characterization of cell surface reactivity.

Antisera reactive with the ganglioside GM2 were raised by immunizing C57BL/6 mice with the C57BL/6 melanoma JB-RH. Fusion with NS-1 was performed using splenic mononuclear cells from a mouse with high antibody titer. An immunoglobulin M monoclonal antibody (monoclonal antibody 5-3) was identified which was reactive with an antigen that was resistant to heat, trypsin, and Pronase. A panel of purified glycolipids was used to determine the specificity of monoclonal antibody 5-3. Reactivity was restricted to N-acetyl- and N-glycolyl-GM2. No reactivity was detected with asialo-GM2 or other gangliosides. Monoclonal antibody 5-3 was used to define the expression of GM2 on the cell surface of cultured human normal and malignant cells. Reactivity was seen with cell lines derived from 8 of 8 astrocytomas, 5 of 5 neuroblastomas, 7 of 9 sarcomas, 4 of 18 human melanomas, 2 of 4 murine melanomas, 4 of 37 epithelial cancers and with 0 of 6 skin fibroblast and 0 of 2 brain fibroblast lines. GM2, like GD2 and GD3, appears to be a differentiation antigen largely restricted to cells of neuroectodermal origin.

Animals↗
PubMed1986

Reducing the cancer risk of 239Pu by chelation therapy.

Groups of adult female C57BL/Do mice were injected intraperitoneally with graded activities of monomeric 239Pu(IV) citrate at 10 weeks of age. Beginning 3 days after plutonium injection, some mice received repeated subcutaneous injections of Zn Na3 diethylenetriaminepentaacetate (Zn-DTPA). Each injection was 37 mumol Zn-DTPA/kg body weight. To evaluate protection from bone sarcoma, brief, intermediate, or protracted chelation therapies were administered to groups of mice. The brief chelation therapy covered a 2-week period, the intermediate therapy 2 months, and the protracted therapy 1 year. The mice were followed throughout life and examined for bone sarcoma. Both skeletal dose and bone sarcoma risk were reduced by chelation. The bone sarcoma incidences in the mice given chelation treatments generally fell below the dose-response curve for the mice not given DTPA, indicating that the cancer risk was reduced more than that corresponding to the decreased skeletal dose. This results suggests that Zn-DTPA preferentially removed Pu from the most carcinogenic locations in the skeleton, such as on bone surfaces near living cells.

Animals↗
PubMedDate not supplied

A case of high-grade endometrial stromal sarcoma arising from endometriosis in the cul-de-sac.

This report describes a rare case of high-grade endometrial stromal sarcoma (ESS) arising from pathologically confirmed endometriosis in the cul-de-sac. A 37-year-old woman presented with irregular menstruation, pelvic pain, and diarrhea. Magnetic resonance imaging and colon biopsy suggested endometriotic nodule of the cul-de-sac. The tumor size was reduced with hormonal therapy, and the residual tumor was excised, resulting in the pathologic diagnosis of endometriosis. Two years later, a soft mass reappeared with rapid growth. Tumor extraction was performed, and the histopathologic diagnosis was high-grade ESS. Neither hormonal therapy nor chemotherapy was effective, and the patient died 6 months postoperatively. ESS should be included in the differential diagnosis of malignant transformation of endometriosis.

Adult↗
PubMed1980

Effect of p15-associated protease from an avian RNA tumor virus on avian virus-specific polyprotein precursors.

A proteolytic activity is associated with structural protein p15 in avian RNA tumor viruses. Its effect on the known intracellular viral polyprotein precursors obtained by immunoprecipitation was investigated. Cleavage of Pr76gag resulted in the sequential appearance of p15, p27, and p19. The intracellular precursor Pr180gag-pol was also cleaved by p15, whereas the intracellular glycoprotein precursors of avian RNA tumor viruses, Pr92env, remained unaffected by p15 under all conditions tested. The specificities of the antibodies used to precipitate the precursors influenced the pattern of intermediates and cleavage products obtained by p15 treatment. If virus harvested from the the Prague strain of Rous sarcoma virus, subgroup C-transformed cells at 15-min intervals was incubated at 37 degrees C for further maturation, RNA-dependent DNA polymerase activity showed an optimum of DNA synthesis with 70S viral RNA or synthetic template-primers after short incubation periods. The presence of additional p15 during incubation resulted in a shift of the enzyme activity peak toward earlier time points. Virus harvested at 3-h intervals contained significant amounts of Pr180gag-pol and Pr76gag. The addition of p15 resulted in the cleavage of Pr180gag-pol and Pr76gag, but only a few distinct low-molecular-weight polypeptides appeared. Treatment of purified RNA-dependent DNA polymerase with p15 in vitro resulted in a disappearance of the beta subunit and an enrichment of the alpha subunit. In addition, a polypeptide of 32 x 10(3) molecular weight was generated. The cleavage pattern observed differed from the one obtained by trypsin treatment.

Animals↗
PubMed2002

Combined heart and lung transplantation for unresectable primary cardiac sarcoma.

OBJECTIVE: The prognosis for patients with primary cardiac sarcoma is poor. Median survival is less than 10 months, especially when complete surgical excision is not feasible. Removal of all cardiopulmonary structures involved by tumor followed by orthotopic allotransplantation has been proposed to improve long-term survival. METHODS: From 1996 through 1999, we performed combined heart and lung resection followed by en bloc heart and bilateral lung transplantation in 4 patients (2 men and 2 women): 2 with inoperable pulmonary arterial sarcoma and 2 with left atrial sarcoma extending into the pulmonary vein. RESULTS: Median age at diagnosis was 39 years (range 37-45 years). All 4 patients were given chemotherapy before transplantation: doxorubicin and ifosfamide in 2 cases, and doxorubicin, ifosfamide, mesna, and dacarbazine in 2 cases. There were no operative deaths. Median survival after transplantation was 31 months (range 5-49 months). All patients had tumor recurrence: local recurrence in the chest (n = 1) and distant metastases in the brain (n = 2) and abdomen (n = 1). One patient remains alive 49 months after disease progression with cerebral metastasis as the only site of recurrence treated with whole-brain irradiation, resection, and stereotactic radiosurgery. CONCLUSIONS: Combined heart and lung transplantation is a technically feasible treatment for highly selected patients with localized advanced primary cardiac sarcomas. The high incidence of metastatic disease, however, limits its utility.

Adult↗
PubMed2005

Massive myeloid sarcoma affecting the central nervous system, mediastinum, retroperitoneum, liver, and rectum associated with acute myeloblastic leukaemia: a case report.

Myeloid sarcomas are extramedullary tumours with granulocytic precursors. When associated with acute myelogenous leukaemia (AML), these tumours usually affect no more than two different extramedullary regions. This report describes a myeloid sarcoma associated with AML with tumour formation at five anatomical sites. The patient was a 37 year old man admitted in September 1999 with a two month history of weight loss, symptoms of anaemia, rectal bleeding, and left facial nerve palsy. The anatomical sites affected were: the rectum, the right lobe of the liver, the mediastinum, the retroperitoneum, and the central nervous system. A bone marrow smear was compatible with AML M2. Flow cytometry showed that the peripheral blood was positive for CD4, CD11, CD13, CD14, CD33, CD45, and HLA-DR. A karyotypic study of the bone marrow revealed an 8;21 translocation. The presence of multiple solid tumours in AML is a rare event. Enhanced expression of cell adhesion molecules may be the reason why some patients develop myeloid sarcomas.

Adult↗
PubMed1981

The continuing challenge of retroperitoneal sarcomas.

Treatment of 158 patients with retroperitoneal sarcomas (1951--1977) resulted in a mean five-year survival of 40% (range 37--45%) after complete excision. Only 22% (range 19--25%) of the patients were free of disease. Survival for five years after incomplete excision was 3%. Operative mortality after complete excision declined from 21 to 2% during this period. Anatomical barriers to wide resection, high-grade histology, and local recurrence were the most important factors determining survival. The need for adjuvant therapy is emphasized by a 77% recurrence rate among patients with apparent complete excision. Brachytherapy (125Iodine, 192Iridium) afterloading techniques and supplemental external radiation are recommended to improve local control and chemotherapy is indicated to diminish the potential for metastatic spread. The contribution of adjuvant therapy after complete excision in this series was difficult to assess because of the number of uncontrolled variables, different histologic types, and limited number of patients treated by multimodality therapy. Although radiation and chemotherapy may be beneficial after incomplete resection, prolonged survival was only seen in patients with liposarcoma and low-grade fibrosarcoma.

Adolescent↗
PubMed2000

Surgical treatment of adult primary hepatic sarcoma.

BACKGROUND: Primary sarcomas of the liver are extremely rare in adults. Optimal therapeutic approaches remain unclear. METHODS: Twenty consecutive adult patients who had surgical treatment for primary hepatic sarcomas were reviewed. Patient age ranged from 23 to 80 years. Other than one patient with primary hepatic angiosarcoma who had a history of thorium dioxide colloid (Thorotrast) exposure 23 years before diagnosis, no predisposing causes were apparent. Nineteen patients had hepatic resection and one patient had an orthotopic liver transplant. No patient received neoadjuvant chemotherapy or radiotherapy but radiotherapy was delivered intraoperatively in one patient. RESULTS: Leiomyosarcoma was the most common histological type of sarcoma diagnosed (five of 20 patients), followed by malignant solitary fibrous tumour (four) and epithelioid haemangioendothelioma (three). Fourteen tumours were high-grade sarcomas and six were low grade malignancies. Thirteen patients developed a recurrence. Distant metastases (ten patients) and intrahepatic recurrence (six) were the predominant sites of initial treatment failure. Six patients received salvage chemotherapy. Histological grade was the only factor significantly associated with overall patient survival (P= 0.03). With complete resection, patients with high-grade tumours had a 5-year survival rate of 18 (95 per cent confidence interval 5-62) per cent compared with 80 (52-100) per cent for patients with low-grade tumours. The 5-year survival rate for all 20 patients was 37 (20-60) per cent. CONCLUSION: Surgical resection is the only effective therapy for primary hepatic sarcomas at present. Better adjuvant therapy is necessary, especially for high-grade malignancies, owing to the high failure rate with operation alone.

Adult↗
PubMed1993

The prognostic significance of the DNA content in Ewing's sarcoma: a retrospective cytophotometric and flow cytometric study.

The DNA content of the cell nuclei of Ewing's sarcoma was analysed by means of cytophotometry in situ with image analysis in Feulgen-stained sections in 37 patients, and by retrospective flow cytometry according to the method of Hedley in 26 patients. Different histogram patterns were obtained: normal unimodal or bimodal DNA distributions and abnormal DNA distributions with one or two stem lines, or an abnormal DNA distribution with no stem lines. Both methods enabled us to make a distinction between two groups of Ewing's sarcomas with a different prognosis. All patients with aneuploid tumours died within 5 years after the initial diagnosis. Eleven of 19 (58%) patients with a normal DNA distribution in their tumour, as determined by cytophotometry, are still alive and in good health with a mean survival period of 7.5 years, ranging from 2 to 19 years. Of the group of patients in which flow cytometry revealed a normal DNA pattern, eight of 15 (53%) are still alive and in good health, with a mean survival period of 8 years. These results indicate that both techniques are reliable methods for obtaining prognostic information in Ewing's sarcomas. However, cytophotometry in situ yielded a better discrimination for the overall survival (P < 0.01) than did flow cytometry (P < 0.05). In 19% of the cases there was a discrepancy between the DNA histograms obtained with the two techniques. In five of 26 cases the DNA distributions were classified as normal by one method and aneuploid by the other. Tumour cell representation or selective loss of cells during enzymatic treatment may be responsible for this discrepancy.

Adolescent↗
PubMed1994

Colorectal cancers of rare histologic types compared with adenocarcinomas.

PURPOSE: To examine clinical characteristics of colorectal cancers of rare histologic types compared with adenocarcinomas. METHODS: Review of a population-based registry with complete ascertainment. RESULTS: There were 7,422 colorectal cancers, 4,900 (66 percent) colonic and 2,522 (34 percent) rectal. Two hundred fifty-five cancers (3 percent) were of nonadenocarcinoma varieties including 75 (33 percent) squamous, 74 (33 percent) malignant carcinoids, 37 (16 percent) transitional cell-like, 25 (11 percent) lymphomas, 9 (4 percent) sarcomas, and 2 (0.9 percent) melanomas. Sixty (1.2 percent) of the colon cancers occurred in the appendix, and proportionately more carcinoids accounted for these tumors. Compared with adenocarcinomas, colonic and rectal carcinoids and colonic lymphomas accounted for a larger proportion of cancers in the younger age groups. The elderly had proportionately fewer colonic carcinoids. Colonic carcinoids, rectal squamous-cell cancers, and rectal transitional cell-like cancers were more common in women. Colonic lymphomas had a worse prognosis than adenocarcinomas. Survival was better with colonic and rectal carcinoids and rectal transitional cell-like cancers than with adenocarcinomas. CONCLUSIONS: Colorectal cancers of histologic varieties other than adenocarcinoma have distinctive epidemiologic and clinical traits.

Adenocarcinoma↗
PubMed1994

Ifosfamide, carboplatin, and etoposide: a new regimen with a broad spectrum of activity.

PURPOSE: To conduct a phase I/II evaluation of the combination of ifosfamide, carboplatin, and etoposide (ICE) to determine toxicity and activity in a variety of refractory malignancies. PATIENTS AND METHODS: Two hundred four patients, 13 to 64 years of age, with a variety of malignancies, including refractory breast cancer and Hodgkin's and non-Hodgkin's lymphoma, were treated with two cycles of ICE, consisting of intravenous ifosfamide 2 g/m2, carboplatin 400 mg/m2, and continuous infusion etoposide 600 mg/m2 administered in divided doses over 2 days. The regimen was repeated at approximately 28-day intervals. RESULTS: One hundred ninety-one patients (94%) received two cycles at full doses and were assessable for response and toxicity. Complete and partial responses were seen in breast cancer (20%, n = 93), non-Hodgkin's lymphoma (30%, n = 37), Hodgkin's disease (60%, n = 10), melanoma (9%, n = 11), a variety of sarcomas (20%, n = 10), and other malignancies (43%, n = 30). Myelosuppression was prominent, with significant neutropenia requiring frequent hospitalization for neutropenic fever, and thrombocytopenia and anemia requiring frequent platelet and RBC transfusions. However, the overall treatment-related mortality rate was only 3%. No other moderate to severe organ toxicity was seen at a frequency of greater than 1%. CONCLUSION: This regimen is active in a variety of refractory malignancies, with significant but tolerable hematologic toxicity. The addition of hematopoietic growth factors may allow further dose escalation.

Adolescent↗
PubMed2003

Surgical treatment of malignant and aggressive bone tumors around the knee by segmental resection and rotationplasty.

In patients having malignant or aggressive bone tumors around the knee joint and requiring amputation, segmental resection and rotationplasty was performed and the clinical results were analyzed. Twenty-six patients underwent segmental resection and rotationplasty between February 1988 and June 1994. The mean follow-up period was 57 (6 - 120) months and the average age of patients was 21.4 (5 - 37) years. Out of 26 patients, there were 18 osteosarcomas (>/= stage IIB), 2 synovial sarcomas, and 6 giant cell tumors. Clinical results were evaluated by the Shriner's rating system. Four patients were excluded due to death or amputation and the remaining twenty-two patients were included for assessment. Eighteen patients had excellent results, 3 good, and 1 fair. Range of motion of the ankle joint was -11 (dorsiflexion) - 80 (plantarflexion) degrees and daily walking activity was possible. Local recurrence developed in 2 patients and distant metastasis in 10. Early complications include 3 thromboses and 1 sepsis, and late complications were 6 nonunion, 2 malrotation and 1 stiffness of the ankle joint. Rotationplasty, which is functionally excellent, may serve as an effective partial limb salvage procedure, especially in patients younger than 10 years old who are expected to have leg length discrepancy or loosening of the tumor prosthesis due to the growth of the medullary cavity or when amputation is inevitable for a wide resection margin.

Adolescent↗
PubMed1978

Calcium requirements for the proliferation of cells infected with a temperature-sensitive mutant of Rous sarcoma virus.

Between 32 degrees and 39 degrees, uninfected normal rat kidney (NRK) cells proliferated minimally, or not at all, in medium containing 0 to 0.01 mM extracellular free calcium. Transformation of NRK cells by wild-type avian sarcoma virus B77 enabled them to proliferate equally rapidly at all temperatures in high (1.25 mM)- or low (0.001 mM-calcium medium. Transformation by the temperature-sensitive LA-23 mutant of Rous sarcoma virus also enabled NRK cells to proliferate in low (0.001 mM)-calcium medium at 32 degrees or 37 degrees. However, the LA-23 NRK cells could not proliferate in low (0.001 mM)-calcium medium at a nonpermissive temperature such as 39 degrees, which prevents expression of other aspects of the transformed phenotype.

Avian Sarcoma Viruses↗
PubMed1990

Disintegration of adhesion plaques in chicken embryo fibroblasts upon Rous sarcoma virus-induced transformation: different dissociation rates for talin and vinculin.

The localization of talin and vinculin in chicken embryo fibroblasts (CEF) during transformation was studied by immunoelectron microscopy. CEF cells were infected with a temperature-sensitive mutant of Rous sarcoma virus. After 16 h at 42 degrees C, transformation was induced by incubation at 37 degrees C for different intervals up to 3 h. Cells were cleaved by "wet cleaving" as reported previously by us (R. Brands and C.A. Feltkamp, 1988, Exp. Cell Res. 176, 309) and labeled with affinity-purified polyclonal antibodies to talin or vinculin, or monoclonal anti-vinculin. We observed a rapid reduction of vinculin in adhesion plaques within 15 min and a much slower dissociation of talin. This was found using single-labeling procedures and also within the same cell using double labeling. Seemingly intact microfilament bundles were observed associated with adhesion plaques that contained relatively little vinculin. These observations show that an early event in src-induced transformation is the release of vinculin from adhesion plaques. Furthermore, since adhesion plaques with attached filament bundles can exist at least transiently with very little or no vinculin present, it seems likely that vinculin is not, or not the only protein, linking actin filaments to adhesion plaques.

Animals↗
PubMed2006

Pelvic reconstruction using saddle prosthesis following limb salvage operation for periacetabular tumour.

PURPOSE: To assess the clinical results of pelvic reconstruction using a saddle prosthesis following limb salvage operation for periacetabular tumour. METHODS: 12 patients with sarcoma and 4 with metastasis involving the pelvis were treated using the saddle prosthesis between 1995 and 2003 inclusive. Wide pelvic resection was performed for all patients with sarcoma and one with a metastatic lesion; intralesional excision of the acetabulum was undertaken for the remaining 3 patients with metastatic lesions. Oncologic prognosis, operation time, postoperative function, and complications were assessed retrospectively. RESULTS: Of the 12 patients with sarcomas, 5 were alive without evidence of recurrence after a mean follow-up of 37 months, one was alive with disease, 3 died of the disease, and 3 of other medical conditions. Respective mean postoperative functional scores according to the Musculoskeletal Tumor Society-International Symposium on Limb Salvage system and the Toronto Extremity Salvage Score were 53 and 64% in patients undergoing wide acetabular resection, and 30 and 42% in patients undergoing intralesional excision of the acetabulum. In patients undergoing wide acetabular resection and intralesional excision of the acetabulum, the mean operation times were 391 and 162 minutes respectively, whereas the mean times to ambulation were 7 and 4 days respectively. Major complications included infection and dislocation. CONCLUSION: Saddle prosthesis arthroplasty is a useful option for pelvic reconstruction following resection of acetabular malignancies. It is associated with a short operation time, rapid recovery, and moderately good postoperative function, but a relatively high risk of complications.

Acetabulum↗