Krown S E
Memorial Sloan-Kettering Cancer Center, New York, NY 10021.
Cancer Detect Prev. 1990;14(3):405-9.
Neoplasms associated with acquired immunodeficiency syndrome (AIDS) present unique therapeutic challenges. High-grade systemic lymphomas, although often responsive to standard chemotherapy, will require the addition of CSFs, infection prophylaxis, and antiretroviral drugs to overcome poor marrow reserves, short response durations, and opportunistic infections. Treatment of primary central nervous system (CNS) lymphomas is complicated by their frequent occurrence as a late complication in debilitated patients. AIDS-associated Kaposi's sarcoma (KS) is a unique neoplasm whose pathogenesis is only beginning to be understood. Although responsive to standard therapy (RT, chemotherapy), considerable attention has been focused on the therapeutic potential of BRMs. Interferon alpha (IFN-alpha), which combines antiviral, antiproliferative, and immunoregulatory activities, has significant anti-KS activity, particularly in symptom-free patients with mild immunosuppression. Preliminary data links IFN-induced regression of KS to its anti-HIV activity and supports a role for endogenous IFN-alpha in the induction of refractoriness to IFN treatment. Recent data suggest synergistic anti-HIV and anti-KS activity for the combination of IFN-alpha and AZT. Additional study is needed to evaluate IFN effects on autocrine growth factors regulating the growth of KS.
与获得性免疫缺陷综合征（艾滋病）相关的肿瘤带来了独特的治疗挑战。高度恶性的系统性淋巴瘤，尽管通常对标准化疗有反应，但仍需要添加集落刺激因子、感染预防药物和抗逆转录病毒药物，以克服骨髓储备差、反应持续时间短和机会性感染等问题。原发性中枢神经系统（CNS）淋巴瘤的治疗较为复杂，因为在身体虚弱的患者中它经常作为晚期并发症出现。艾滋病相关的卡波西肉瘤（KS）是一种独特的肿瘤，其发病机制才刚刚开始被了解。尽管对标准治疗（放疗、化疗）有反应，但人们相当关注生物反应调节剂的治疗潜力。具有抗病毒、抗增殖和免疫调节活性的α干扰素（IFN-α）具有显著的抗KS活性，特别是在免疫抑制较轻且无症状的患者中。初步数据将IFN诱导的KS消退与其抗HIV活性联系起来，并支持内源性IFN-α在诱导对IFN治疗产生耐药性方面的作用。最近的数据表明，IFN-α与齐多夫定联合使用具有协同抗HIV和抗KS活性。需要进一步研究来评估IFN对调节KS生长的自分泌生长因子的影响。
