Aboulafia, D

Bower, M

Dezube, BJ

Gaughan, EM

Pantanowitz, L

Infectious Agents and Cancer

Harvard University - DASH 

 HIV-associated bladder cancer: diagnosis and management  (Article begins on next page)The Harvard community has made this article openly available.Please share how this access benefits you. Your story matters.Citation Pantanowitz, L, EM Gaughan, BJ Dezube, M Bower, and DAboulafia. 2009. “HIV-associated bladder cancer: diagnosis andmanagement.” Infectious Agents and Cancer 4 (Suppl 2): P34.doi:10.1186/1750-9378-4-S2-P34. http://dx.doi.org/10.1186/1750-9378-4-S2-P34.Published Version doi:10.1186/1750-9378-4-S2-P34Accessed February 17, 2015 8:34:26 AM ESTCitable Link http://nrs.harvard.edu/urn-3:HUL.InstRepos:13581178Terms of Use This article was downloaded from Harvard University's DASHrepository, and is made available under the terms and conditionsapplicable to Other Posted Material, as set forth athttp://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAABioMed  CentralPage 1 of 1(page number not for citation purposes)Infectious Agents and CancerOpen Access Poster presentationHIV-associated bladder cancer: diagnosis and managementL Pantanowitz*4, EM Gaughan1, BJ Dezube1, M Bower2 and D Aboulafia3Address: 1Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA, 2Chelsea and Westminster Hospital, London, UK, 3University of Washington, Seattle, Washington, USA and 4Baystate Medical Center, Tufts University School of Medicine, Springfield, Massachusetts, USA* Corresponding author    IntroductionChronic HIV infection has been associated with anincreased incidence of non AIDS-defining cancers. Todate, only a limited number of cases of bladder cancerhave been reported in association with HIV infection.Therefore, the aim of this study was to investigate a seriesof HIV-associated bladder cancer cases.MethodsA retrospective study was performed involving HIV posi-tive patients with concomitant bladder cancer, combiningcases from multiple institutions with published casereports. Data were extracted regarding patient demo-graphics (age, gender), HIV status (CD4+ cell count, HIVviral load), clinical presentation, pathology, cancer treat-ment, and outcome. Accrued data were analyzed usingdescriptive statistics.ResultsA total of 11 patients were identified with an average ageof 53 years (range 33 to 67), most of whom were male(M:F 9:2). Their median CD4 cell count was 280 cells/mm3 (range 106 – 572 cells/mm3) and median HIV load<50 copies/mL (range <50 – 665,000 copies/mL). Five(45%) patients smoked tobacco, two had recurrent cysti-tis, two had bladder calculi, and one patient had previouspelvic radiation therapy for cervical cancer. Nine (82%)presented with hematuria. Less common presentationsincluded lower abdominal pain, irritative urinary symp-toms (frequency, urgency and/or dysuria), and weightloss. Most cases (10/11) had transitional cell carcinomaand one person had squamous cell carcinoma. At presen-tation, two cases had stage 0a disease, five had stage I dis-ease, and two stage IV disease. Treatment withtransurethral resection of bladder tumor (TURBT) was fol-lowed by intravesical or systemic chemotherapy, cystec-tomy and/or radiation. Intravesical mitomycin C orepirubicin was used, despite the fact that BCG in one casedid not cause complications. Several patients (64%) werealive following therapy, although many (71%) sufferedfrom local relapse and metastatic disease.ConclusionBladder cancer should be added to the growing list ofNon-AIDS defining cancers likely to be encountered inHIV-infected patients now living longer with controlledHIV disease. Afflicted patients are likely to present at ayounger age and with only mild immunosuppression.Hematuria, dysuria, frequency and/or urgency in an HIV-infected patient warrants complete evaluation, includinga work up for bladder cancer. Although most patients pre-sented with early stage disease, the course for their bladdercancers was notable for frequent relapses and subsequentmetastases. HIV positive individuals should be counseledon the potential risks (e.g., smoking) of bladder cancer.from 11th International Conference on Malignancies in AIDS and Other Acquired Immunodeficiencies (ICMAOI): Basic, Epidemiologic, and Clinical ResearchBethesda, MD, USA. 6–7 October 2008Published: 17 June 2009Infectious Agents and Cancer 2009, 4(Suppl 2):P34 doi:10.1186/1750-9378-4-S2-P34<supplement> <title> <p>Proceedings of the 11th International Conference on Malignancies in AIDS and Other Acquired Immunodeficiencies (ICMAOI): Basic, Epidemiologic, and Clinical Research</p> </title> <sponsor> <note>Publication of this supplement was made possible with support from the Office of HIV and AIDS Malignancy, National Cancer Institute, National Institutes of Health.</note> </sponsor> <note>Meeting abstracts – A single PDF containing all abstracts in this Supplement is available <a href="http://www.biomedcentral.com/content/files/pdf/1750-9378-4-S2-full.pdf">here</a>.</note>  <url>http://www.biomedcentral.com/content/pdf/1750-9378-4-S2-info.pdf</url> </supplement>This abstract is available from: http://www.infectagentscancer.com/content/4/S2/P34© 2009 Pantanowitz et al; licensee BioMed Central Ltd. 

HIV-associated bladder cancer: diagnosis and management

http://dash.harvard.edu/bitstream/handle/1/13581178/4261808.pdf?sequence=1

HIV-associated bladder cancer: diagnosis and management

Abstract

Similar works

Full text

Available Versions

Harvard University - DASH