Stellenbosch University - Scopus Tygerberg Hospital Publications
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Browsing Stellenbosch University - Scopus Tygerberg Hospital Publications by Author "Abayomi, E. A."
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- ItemAIDS defining lymphomas in the era of highly active antiretroviral therapy (HAART) - An African perspective(2007) Sissolak, G.; Abayomi, E. A.; Jacobs, P.The intermediate to high grade B-cell non-Hodgkin lymphomas are now one of three malignant AIDS defining conditions. The others being Kaposi's sarcoma and cervical carcinoma. While co-infection with oncogenic agents including the human herpes 8 or Epstein-Barr virus offer targets in preventive treatment strategies for these AIDS defining lymphomas (ADL), administration of highly active antiretroviral therapy leading to immune reconstitution permits use of standard or even high-dose cytotoxic drug regimens with curative intent. It is not certain whether this should be done concomitantly or sequentially. Additional benefit may derive from infusional or high-dose chemotherapy regimens depending on the histological subtype while use of monoclonal antibodies such as rituximab or immunohaematopoietic stem cell transplantation needs to be further evaluated within controlled studies. Socio-economic considerations have an impact especially in resource limited settings while availability of tools for appropriate geno-phenotypic diagnosis and immunological monitoring such as the CD4 cell count will play an important role in the risk stratification as well as disease management. While it is generally accepted that the impact of HAART has an overall benefit both in incidence and treatment outcome in ADL, the expanded access to HAART programs are falling short of all targets in Africa. Accordingly focus is given to some of these controversies, including epidemiology, pathogenesis, clinical features, therapeutic options and ethical considerations. © 2007 Elsevier Ltd. All rights reserved.
- ItemFlow cytometry as the spearhead for delivering sustainable and versatile laboratory services to HIV-burdened health care systems of the developing world: A Caribbean model(2008) Abayomi, E. A.; Landis, R. C.HIV is targeting the developing nations of the world, threatening their economic development, overwhelming public health systems, and depleting human capital. The Caribbean is no exception, with the second highest incidence of HIV/AIDS outside Sub-Saharan Africa, sharing similar mixed fortunes from a postcolonial heritage, limited resources, and an HIV population dispersed in small population centers. Here we share the experience of Barbados, an island state of 280,000 people, in mounting a holistic and sustainable program against HIV/AIDS. At the forefront of this response has been the growth in clinical flow cytometry used for CD4 monitoring, which has prompted a welcome expansion in diagnostic capacity even beyond HIV/AIDS. A pan-Caribbean extension to Barbados' program has been the founding of the Caribbean Cytometry & Analytical Society (CCAS), which acts as a regional forum to accelerate technology transfer and develop the human resources needed to mount an effective response against HIV/AIDS. The 4th CCAS workshop in 2007 produced a consensus statement on the desirable characteristics for a "diagnostic dream machine": a simple-to-use, rugged flow cytometer capable of carrying out multiple diagnostic functions at the point of patient care in rural or island settings of the developing world, including CD4 count, blood count, and opportunistic infections, without the need for a supply cold-chain or dependable power source. It is our ambitious vision that the spread of flow cytometry, primarily to monitor CD4 in HIV/AIDS, can act as a Trojan horse to deliver better general and specialized diagnostic services to the developing world. © 2008 Clinical Cytometry Society.
- ItemImpact of the HIV epidemic and Anti-Retroviral Treatment policy on lymphoma incidence and subtypes seen in the Western Cape of South Africa, 2002-2009: Preliminary findings of the Tygerberg Lymphoma Study Group(2011) Abayomi, E. A.; Somers, A.; Grewal, R.; Sissolak, G.; Bassa, F.; Maartens, D.; Jacobs, P.; Stefan, C.; Ayers, L. W.The Tygerberg Lymphoma Study Group was constituted in 2007 to quantify the impact of HIV on the pattern and burden of lymphoma cases in the Western Cape of South Africa which currently has an HIV prevalence of 15%. South Africa has had an Anti-Retroviral Treatment (ART) policy and a roll-out plan since 2004 attaining 31% effective coverage in 2009. This study is designed to qualify and establish the impact of HIV epidemic and the ARV roll-out treatment program on the incidence of HIV Related Lymphoma (HRL). Early data document that despite the ART roll out, cases of HRL are increasing in this geographical location, now accounting for 37% of all lymphomas seen in 2009 which is an increase from 5% in 2002. This is in contrast to trends seen in developed environments following the introduction of ART. Also noted are the emergence of subtypes not previously seen in this location such as Burkitt and plasmablastic lymphomas. Burkitt lymphoma is now the commonest HRL seen in this population followed by diffuse large B-cell lymphoma subtypes. The reasons for this observed increase in HRL are not ascribable to improved diagnostic capacity as the tertiary institute in which these diagnoses are made has had significant expertise in this regard for over a decade. We ascribe this paradoxical finding to an ART treatment environment that is ineffective for a diversity of reasons, paramount of which are poor coverage, late commencement of ART and incomplete viral suppression. © 2011.
- ItemUse of novel proteosome inhibitors as a therapeutic strategy in lymphomas current experience and emerging concepts(2007) Abayomi, E. A.; Sissolak, G.; Jacobs, P.Precedent from preclinical experiments coupled with two pivotal phase 2 studies in myeloma has focused attention on a potential role for ubiquitin-proteasome pathway in modulating a number of events that occur commonly in the neoplastic process involving proteins in the regulation of cells cycling, growth and differentiation. This influence is vested in the proteasomes which are large complexes of proteolytic enzymes responsible for degradation of many of these intracellular messengers. Logically interest has centred on molecules having the capacity to influence, by degradation, such molecules and although a number of agents are in development bortezomib is the only one currently in clinical use. Velcade, formerly PS-341, is a novel dipeptide boronic acid capable of reversibly inhibiting the 26S proteasome through a range of activities. The latter are anti-proliferative and proapoptotic with the latter blocking nuclear transcription via NF-κ B in addition to down regulating adhesion and inhibiting angiogenesis. Additional changes are mediated in protein folding within the endoplasmic reticulum and contribute to cell death. These concepts are given focus by considering their introduction into treatment of lymphoreticular malignancy. © 2007.