HIV and HTLV-1 Associated Malignancies

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Details:

J Sparano (Ed)
Published by Kluwer (2001)
ISBN: 0-7923-7220-4. 372 pages plus index.
RRP: US$200


This relatively small but not inexpensive textbook comprehensively examines biological and clinical aspects of malignancies associated with the retroviral infections, HIV and HTLV-1. Malignancy associated with HIV infection may present in many unusual and at times dramatic forms to many different types of clinician. While complications of HIV infection, especially opportunistic infections and Kaposi’s sarcoma have dramatically declined with improvements in anti-retroviral therapy there has been a lesser decline in the incidence of NHL, to the extent it has become a common initial presentation of AIDS. A number of other malignancies have been associated with HIV infection and the clinical manifestations of HIV infection itself may complicate the management of cancer in these patients. It is important cancer therapists be aware of these issues. Somewhat in contrast HTLV-1 associated leukaemia/lymphoma remains an exceptionally rare disease except in certain geographical areas such as the Caribbean and southern Japan with a more typical presentation for the cancer clinician. Why other cancers associated with infection such as MALT lymphoma or other forms of chronic immunosuppression such as the congenital immunodeficiency disorders with their high incidence of malignancy were not included remains unknown.

The editor gives no introduction or overview chapter to explain the rationale for the text. Be that as it may the quality of the content delivered is excellent. All chapters seem up-to-date and well referenced, highlight controversies in the area without ambiguity and are easy to read. The clinical chapters in particular are excellent and give clear and sensible recommendations regarding management. Their principle based approach makes it unlikely they will quickly become out-of-date. The chapter on mechanisms of lymphomagenesis has a surfeit of good content but disappoints by not giving the reader a more general overview to help understand the interplay of the many and varied factors discussed.

Any criticisms are relatively minor. It would have been helpful to have included a chapter on the protean presentations of malignancy associated with HIV infection and the appropriate diagnostic work-up. Occasionally a reference seems lacking and the contextual editing falls down with missed typographical errors and repetitive information across some chapters. Perhaps this is a problem for the ageing, hypermetropic reviewer but the system of referencing seems particularly galling as it varies the line spacing making the text more difficult to follow.

For the clinician involved in the treatment of HIV infection or the cancer specialist who may at some time be involved in the management of these conditions this would be an excellent addition to their library and would ably augment a more general library in a hospital or clinic.

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