Zwerski S, Walsek C, Balis F, Jaffe E, Wood LV; IAS Conference on HIV Pathogenesis and Treatment (2nd : 2003 : Paris, France).
Antivir Ther. 2003; 8 (Suppl.1): abstract no. 1076.
Social and Scientific Systems, Inc, Silver Spring, MD
At the time of presentation the patient was a 13 year old male with HIV infection. He was severely immunocompromised with an absolute CD4 lymphocyte count of <50 cells/mm3 for greater than 8 years. He had multiple manifestations of HIV disease including growth failure necessitating a gastrostomy tube as well as bone marrow suppression requiring transfusions, and multiple opportunistic infections. His diagnosis of small cell neuroendocrine carcinoma was preceded by a 3 month history of wheezing and dry cough. He presented to the hospital in severe respiratory distress and after undergoing a three dimensional CT scan a biopsy of a large subcarinal mass revealed a small cell neuroendocrine carcinoma. The patient was treated with palliative radiation therapy and achieved resolution of the tumour. Upon evaluation of one of the follow-up CT scans performed, as part of the ongoing monitoring, approximately 6 months after the conclusion of radiation it was noted that there were masses in the lung parenchyma and the liver. Needle biopsy revealed metastatic small cell neuroendocrine carcinoma and a course of 5 cycles of cisplatin and etopocide was undertaken. There was complete resolution of the lesions and the patient achieved a full recovery. He is now attending college and leading a full life. The initiation of HAART therapy prior to the course of chemotherapy is considered to be a major contributing factor in the patient's recovery underscoring the dramatic impact that such therapy can make even in the bleakest of circumstances. Thus far no such case of small cell neuroendocrine carcinoma has been reported in the literature for an HIV-infected patient so young nor have there been any reports of a recovery so dramatic. As patients are living longer there is a possibility that clinicians and researchers will see more malignancy in patients that, in the pre-HAART era, may have already died due to the lack of good treatments for HIV disease. Our case illustrates the point that HAART therapy and aggressive chemotherapy can result in good outcomes for paediatric HIV patients.
Publication Types:
Keywords:
- AIDS Vaccines
- Acquired Immunodeficiency Syndrome
- Adolescent
- Antineoplastic Combined Chemotherapy Protocols
- Antiretroviral Therapy, Highly Active
- Carcinoma, Small Cell
- Child
- Cisplatin
- HIV Infections
- HIV Seropositivity
- Humans
- Immunocompromised Host
- Male
- drug therapy
- immunology
- secondary
- therapy
Other ID:
UI: 102263354
From Meeting Abstracts