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Background The effects of Human Immunodeficiency Virus (HIV) on the Overall Survival (OS) in patients diagnosed with Acute Myeloid Leukaemia (AML) are not well documented. All studies to date have been with small sample sizes and based on collections of case studies from different facilities with different treatment protocols, as a result it has been difficult to draw definitive conclusions. Method This retrospective record review of a cohort of AML patients (n=304) treated at a single site between 2000 and 2017 was conducted. Age (16-93 years), gender (Male: n=157 ; Female: n=138), ECOG PS (Eastern Co-Operative Oncology Group Performance Status), FAB (French-American-British) staging, blast count, CD4 count, HIV viral load, financial status, response to treatment as measured on bone marrow biopsy and OS were measured. The OS was compared for HIV status. Further comparisons were conducted in a sub-group where age, ECOG PS and FAB staging were controlled. Results 210 (69.07%) were HIV negative, 31 (10.1%) were HIV positive, 63 (20.7%) had an unknown HIV status. A statistically significant difference was found between HIV negative and HIV positive groups’ OS (563 vs. 121 days ; P<0.01)(HR 2.02 ; 95% CI 1.36 - 2.99) in the main analysis. This difference was also noted when patients who were not treated for AML were excluded from the comparison (OS, 740 vs 194 days, P<0.01)(HR, 2.10 ; 95% CI 1.26-3.50). In the main analysis mean ECOG PS was better in the HIV negative population compared to the positive population (1.80 vs. 2.06). In the controlled group sub-study, where Age, ECOG PS and FAB staging were controlled, the OS between HIV positive and HIV negative patients was not statistically significant (141 days vs. 121 days) (P=0.17; 95% CI). CD4 counts ranged from 29 – 1416, with a mean CD4 of 432 on presentation. No statistically significant difference could be found between CD4 and OS (HR, 1.0 ; 95% CI 0.99-1.00), possibly due to very few patients presenting with a low CD4 count. HIV Viral Loads ranged from <100 – 106640. Similarly, no statistically significant difference was found between HIV Viral Load and OS (HR 0.99 ; 95% CI 0.99-1.00). Conclusion HIV has a negative impact upon the OS of patients with AML. HIV appears to impact on OS as a chronic comorbidity by affecting ECOG PS on presentation, reducing their chance of being treated as well as possibly reducing a patients’ functional reserve. This impact does not appear to be as a result of a direct interaction between the HIV and AML disease processes, as when controlling for other factors that may influence OS there is no statistically significant difference in OS between HIV positive and negative patients. / Dissertation (MSc (Medical Oncology))--University of Pretoria, 2019. / This thesis/dissertation is under embargo until September 2023. / Medical Oncology / MSc (Medical Oncology) / Restricted

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Anaplastic large-cell lymphoma (ALCL) is a CD30 + lymphoproliferative disorder that may manifest with skin involvement.1 We present a rare case of Agent Orange-induced ALCL with cutaneous involvement of the hand, surgical excision, and follow-up treatment.

<p>2022-03-22</p>

<p>2022-03-21</p>

Breast cancer is a leading cancer among women and is a major cause of death worldwide. While not just one disease, breast cancer encompasses many biologically different subtypes with distinct pathologies and clinical ramifications. In the case of estrogen receptor (ER) positive breast cancer, estrogens stimulate mammary epithelial cell proliferation and contribute to the development and progression of the disease. To treat ER-positive breast cancer patients, endocrine targeted therapies such as tamoxifen are commonly used. However, 40–50% of these patients do not respond or develop resistance to these therapies, and therefore additional treatment options are needed. In the case of triple negative breast cancer (TNBC), there is a lack of expression of the ER, progesterone receptor (PR) and the human epidermal growth factor receptor 2 (HER2) and this subtype has the poorest prognosis. There are currently very limited therapies available for TNBC, and due to the receptor status, endocrine therapies are ineffective. This leaves TNBC patients with chemotherapy and radiation as the only options, and therefore additional treatments are urgently needed. CAPER is a coactivator of activating protein-1 (AP-1) (interacting specifically with the c-Jun component) and the ER and is known to be involved in human breast cancer pathogenesis. Not only has CAPER shown a role in ER-positive breast cancer but recent data has also demonstrated a role for CAPER in TNBC. In normal breast tissue, CAPER is not detectable or expressed at low levels. However, in both ER-positive and TNBC, CAPER exhibits a significantly higher level of expression. Additionally, it has been shown that when CAPER expression is reduced via knockdown cell proliferation is decreased in both in vitro and in vivo settings. Due to CAPER’s role in both ER-positive and TNBC, disrupting the interaction of CAPER with the ER and/ or c-Jun could be a novel approach to treat breast cancer patients. The work described herein will review the development and in vitro testing of CAPER peptides to inhibit the coactivator activity of CAPER with c-Jun and/or the ER.

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