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Metronomic Therapy for HIV-Associated Malignancies

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Molecular Basis for Therapy of AIDS-Defining Cancers

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Abstract

Therapeutic complications following maximum tolerated dose cytotoxic chemotherapy are a reality of current cancer care treatment regimens and protocols. These complications include bone marrow suppression with anemia, bleeding, and neutropenia and without appropriate supportive care, result in unacceptably high morbidity and mortality rates. Over 30 million people worldwide are infected with HIV, and of these, the vast majority live in sub-Saharan Africa. Many patients with AIDS are also malnourished and so are especially vulnerable to the mucositis and weight loss that often accompanies chemotherapy further compounding the inherent risks of myelosuppressive chemotherapy. In addition, HIV infection is thought to cause abnormalities in hematopoiesis, compounding the myelotoxicity of cytotoxic therapy. Thus, myelotoxicity is a major complication following the delivery of cytotoxic therapy at maximum tolerated doses to treat AIDS-associated malignancies in developing countries. Alternative approaches to the management of AIDS-associated malignancies are needed in resource-poor countries. In this chapter, we will describe a new approach for the delivery of cytotoxic drugs – metronomic therapy – that reduces the toxicity associated with the delivery of chemotherapeutic drugs at maximum tolerated doses.

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Authors and Affiliations

  1. Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, NY, 13210, USA

    Rosemary Rochford Ph.D

  2. Medicine-Hematology/Oncology and the Laurence and Jean DeLynn Chair of Oncology, Mary Babb Randolph Cancer Center, West Virginia University, Morgantown, WV, 26506-9300, USA

    Scot C. Remick M.D

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  1. Rosemary Rochford Ph.D
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Correspondence to Rosemary Rochford Ph.D .

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Editors and Affiliations

  1. Lineberger Comprehensive, Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA

    Dirk P. Dittmer

  2. Cancer Center, Memorial Sloan-Kettering, York Ave. 1275, New York, 10065, New York, USA

    Susan E. Krown

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Rochford, R., Remick, S.C. (2010). Metronomic Therapy for HIV-Associated Malignancies. In: Dittmer, D., Krown, S. (eds) Molecular Basis for Therapy of AIDS-Defining Cancers. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-1513-9_12

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