Malignancies in South African Children With HIV

被引：41

作者：

Davidson, Alan ^{[1
,2
]}

Wainwright, Rosalinda D. ^{[5
]}

Stones, David K. ^{[8
,9
]}

Kruger, Mariana ^{[3
,4
]}

Hendricks, Marc ^{[1
,2
]}

Geel, Jennifer ^{[6
]}

Poole, Janet ^{[6
]}

Reynders, David ^{[7
]}

Omar, Fareed ^{[7
]}

Mathew, Rema ^{[10
,11
]}

Stefan, D. Cristina ^{[3
,4
]}

机构：

[1] Red Cross Childrens Hosp, Dept Paediat & Child Hlth, ZA-7700 Cape Town, Western Cape, South Africa

[2] Univ Cape Town, Cape Town, Western Cape, South Africa

[3] Tygerberg Hosp, Dept Paediat & Child Hlth, Cape Town, Western Cape, South Africa

[4] Univ Stellenbosch, Cape Town, Western Cape, South Africa

[5] Univ Witwatersrand, Chris Hani Baragwanath Acad Hosp, Dept Paediat & Child Hlth, Johannesburg, South Africa

[6] Univ Witwatersrand, Charlotte Maxeke Johannesburg Acad Hosp, Dept Paediat & Child Hlth, Johannesburg, South Africa

[7] Univ Pretoria, Steve Biko Acad Hosp, Dept Paediat, ZA-0002 Pretoria, South Africa

[8] Univ Acad Hosp Complex, Dept Paediat & Child Hlth, Bloemfontein, Free State, South Africa

[9] Univ Free State, Bloemfontein, Free State, South Africa

[10] Frere Hosp, Dept Paediat, East London, Eastern Cape, South Africa

[11] Walter Sisulu Univ, East London, Eastern Cape, South Africa

来源：

JOURNAL OF PEDIATRIC HEMATOLOGY ONCOLOGY | 2014年 / 36卷 / 02期

关键词：

pediatric oncology; Africa; HIV; infectious disease; VIRUS-INFECTED CHILDREN; EPSTEIN-BARR-VIRUS; KAPOSIS-SARCOMA; CHILDHOOD-CANCER; ITALIAN-REGISTER; UNITED-STATES; AIDS; PEOPLE; RISK; NEUTROPENIA;

D O I：

10.1097/MPH.0b013e31829cdd49

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Objectives: In 2008 the South African Children's Cancer Study Group decided to review the epidemiology, management, and chemotherapy response of HIV-positive children with malignancy. Methods: This is a retrospective analysis of data collected from the records of HIV-positive children diagnosed with malignancy at 7 university-based pediatric oncology units serving 8 of the 9 provinces in South Africa. Results: Two hundred eighty-eight HIV-positive children were diagnosed with 289 malignancies between 1995 and 2009. Age at diagnosis ranged from 17 days to 18.64 years; median 5.79 years. Of the 220 HIV-associated malignancies, there were 97 Kaposi sarcomas, 61 Burkitt lymphomas, 47 other B-cell lymphomas including 2 primary central nervous system lymphomas, 12 Hodgkin lymphomas, and 3 leiomyosarcomas. Sixty-nine patients presented with non-AIDS-defining malignancies. More than 80% presented with advanced disease. Most patients (76.7%) were naive to antiretroviral therapy; 22.2% did not have access because it only became available in public hospitals in 2004. One hundred ninety-seven children were treated with curative intent; 91 received palliative care due to advanced malignancy and/or advanced HIV disease. Nearly one third had coexisting pathology, mostly tuberculosis. Overall survival for the whole group was 33.7%, but was 57.8% for those treated with antiretroviral therapy and chemotherapy. Conclusions: The study shows more Kaposi sarcoma and fewer primary central nervous system lymphomas among HIV-positive children than that is reported in the developed world, but confirms a higher incidence of non-Burkitt B-cell lymphoma than in HIV-negative children. The high number of non-AIDS-defining malignancies underscores the prevalence of HIV-AIDS in South Africa. The overall survival should improve with universal access to antiretrovirals and earlier diagnosis.

引用

页码：111 / 117

页数：7

共 46 条

[41] Kaposi Sarcoma in South African Children [J].