Treatment for leiomyosarcoma and leiomyoma in children with HIV infection

Department of Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Cochrane database of systematic reviews (Online) (Impact Factor: 6.03). 05/2010; 5(5):CD007665. DOI: 10.1002/14651858.CD007665.pub2
Source: PubMed


There is a lack of reliable evidence on interventions for treating leiomyosarcoma and leiomyoma in children with HIV/AIDS. Smooth muscle tumour (SMT) is a type of cancer composed of leiomyoma and leiomyosarcoma. Although there are many more cases among adults with HIV infection than with children, an increasing number of SMTs have been described in HIV-infected children. Leiomyosarcoma has become the second most frequent malignancy in children with HIV infection or other immunodeficiency diseases in the United States; however, there is a lack of uniform and effective therapies and their efficacy and safety still are unknown. No randomised controlled trials and clinical controlled trials of interventions for leiomyosarcoma and leiomyoma in children with AIDS were found that rigorously evaluated effectiveness.

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    • "Although it accounts for only 2–4% of childhood soft tissue sarcomas, it is now the second most frequent malignancy in children infected with HIV or other immunodeficiency diseases in the United States [38]. The prognosis is worst in HIV-infected children compared with non-infected patients, and there is currently a lack of uniform and effective therapies [38] "
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    ABSTRACT: Highly Active Antiretroviral Therapy (HAART) changed the natural history of pediatric HIV infection. This review focuses on trends of HIV-associated cancers in childhood in the HAART era and analyses potential pathogenetic mechanisms. HAART reduced AIDS-defined malignancies (ADM), but incidence of several non-ADM is increasing. HIV-associated immune activation and inflammation, promoting tumorigenesis, can only partially be reduced by HAART. In addition, HIV-infected children may undergo accelerated immune senescence that favors cancer development. How HAART affects this condition is an open question. Lastly, there is no evidence that prenatal exposure to HAART increases the risk of cancer in childhood, but long-term studies are needed.
    Cancer letters 02/2014; 347(1). DOI:10.1016/j.canlet.2014.02.002 · 5.62 Impact Factor
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    • "Yin et al. recently reviewed the literature regarding therapeutic strategies for treating leiomyoma and LMS in children with AIDS. Based on the fact that there are no randomized or clinical controlled trials and most of the data is based on case reports and small series, they conclude that it is likely best to treat each patient with a case-by-case manner until larger, more rigorous studies are carried out [57]. In some cases, conservative management and simple observation alone may be appropriate for some of these extremely ill patients [27, 32]. "
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    ABSTRACT: The number of reported cases of smooth muscle tumor (SMT) arising in patients with AIDS has been increasing since the mid-1990s. The aim of this study is to characterize the epidemiology, clinical manifestations, pathologic features, prognosis and, management of Epstein-Barr virus-related SMT (EBV-SMT) in patients with AIDS. An English language literature search identified 53 articles including 64 reported cases of EBV-SMT. The majority of these reports involved patients who were young, severely immunosuppressed, and had multifocal tumors. The central nervous system was the most common site to be involved. Histologically, tumors had smooth muscle features and were immunoreactive for muscle markers and all but two tumors demonstrated the presence of EBV by either immunohistochemistry, in situ hybridization, and/or PCR. While mitoses and/or necrosis were used to separate leiomyoma from leiomyosarcoma, these features did not correlate with clinical outcome. Treatment included primarily resection, and less often radiotherapy, chemotherapy and highly active antiretroviral therapy (HAART). Overall, EBV-SMTs appear to have variable aggressiveness and clinical outcome and may exhibit a more favorable prognosis compared to conventional leiomyosarcoma. Tumor-related death from EBV-SMT occurred in only 4 of 51 patients.
    Pathology Research International 03/2011; 2011(2):561548. DOI:10.4061/2011/561548
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    ABSTRACT: EBV-associated smooth muscle tumors are found in immunocompromised patients, most commonly HIV/AIDS. We present a 12-year-old girl with the first documented case of EBV-related smooth muscle tumors in the presence of a rare classic NK cell deficiency. This sheds light on the role of NK cells in controlling EBV-related smooth muscle tumors.
    Blood 03/2012; 119(17):4009-12. DOI:10.1182/blood-2011-10-385377 · 10.45 Impact Factor
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