Human immunodeficiency virus-related cancer in children: Incidence and treatment outcome - Report of the Italian Register

Purpose: to outline the incidence, presenting features, treatment response, and outcome of human immunodeficiency virus (HIV)-associated malignancies in infancy and childhood, together with the estimated risk of HIV-associate d cancer in children born to mothers infected with HIV. Patients and Methods: The Italian Register for HN Infection in Children col lected data by specific registration and follow-up forms. By March 1999, 5, 060 children were recruited, including 4,889 with perinatal exposure to HIV -1. Overall, 1,331 infected children were enrolled onto the Register and cl assified according to current Centers for Disease Control criteria; of them , 1,163 were vertically infected (24% of those with perinatal exposure). Of these 1,163, 569 (49%) were considered to have been prospectively followed -up since they had been registered at birth or within the first 3 months of age. Results: Of the 1,331 children observed for a median time of 6.5 years, 35 developed 36 malignancies, four of which occurred in patients with blood-bo rne risk. For the 1,163 vertically infected children, the cumulative number of years of observation was 7,178 child-years and the cumulative incidence of HIV-associated tumors was 4. 18 per 1,000 children/yr (95% confidence i nterval [CI], 2.92 to 5.98). When only the 569 vertically infected children prospectively followed up since birth were considered, the cumulative numb er of years of observation was 2,803 child-years. In this group, 10 rumors were observed, with a cumulative incidence of HIV-associated tumors of 3.57 per 1,000 children per year (95% CI, 1.92 to 6.63). Conclusion: The risk of cancer was significantly higher but nor restricted to symptomatic and/or immune-compromised children. Cancer-directed treatmen t should be given promptly to these patients, who have ct fair chance to su rvive their tumor in view of potential highly aggressive antiretroviral the rapy-associated improvement in survival and quality of life. (C) 2000 by Am erican Society of Clinical Oncology.