BioMed Central

Prilozi Makedonska Akademija Na Naukite I Umetnostite Oddelenie Za Bioloski I Medicinski Nauki Contributions Macedonian Academy of Sciences and Arts Section of Biological and Medical Sciences, 2009

A b s t r a c t: Aim: To investigate the prevalence, clinical manifestations and outcome of Kaposi's sarcoma in Croatian renal transplant recipients.

Clinical Transplantation, 2016

Background: The aim of this study was to determine the overall and specific incidences of Kaposi's sarcoma (KS) in a cohort of 568 kidney transplant recipients (KTR) in a single North African Mediterranean center. Patients and Methods: The records of 568 patients, who underwent kidney transplantation (KT) between June 1986 and December 2013, were retrospectively reviewed. Incidence was calculated by dividing the number of the different events by the total duration of follow-up. Survival rates and cumulated frequencies of KS were calculated according to the actuarial method. Results: Twelve patients developed KS corresponding to an overall prevalence of 2.1% and an annual incidence of 0.27% patient-years. Median time to diagnosis of KS was 23.3 months. Eleven patients presented with skin lesions; three had oral localizations and one had conjunctival involvement. Asymptomatic gastric localization was observed in one patient. Therapeutic management, consisting in reduction of immunosuppression in all cases and their conversion to sirolimus in four patients, resulted in complete regression of KS in seven patients. Graft loss was observed in three cases and four patients died of unrelated-KS causes. Conclusion: KS is the most post KT malignancy observed in our country and is characterized by a predominance of limited superficial forms.

Iranian journal of kidney diseases, 2007

Skin cancers are the most common tumors among transplant recipients who receive immunosuppressive agents. Kaposi sarcoma (KS) is one of the most common malignancies to occur in kidney transplant recipients, especially in the Middle East countries. Its prevalence in comparison with other neoplasms is also relatively higher in Iran (> 35%). The KS-associated herpesvirus or human herpesvirus 8 is a newly discovered herpesvirus found in all forms of the KS including those among immunosuppressed transplant recipients. Kaposi sarcoma usually regresses after withdrawal or reduction of immunosuppressive agents. A wide variety of therapies have been used for KS, including radiotherapy and administration of interferon and different chemotherapeutic regimens. Sirolimus exhibits antiangiogenic activity related to impaired production of vascular endothelial growth factor and limited proliferative response of endothelial cells to the stimulation by vascular endothelial growth factor. Therefore...

International Journal of Dermatology, 1991

International Urology and Nephrology, 2009

American Journal of Medicine, 1979

Journal of the American Academy of Dermatology, 2019

Background: Systemic therapeutic management of post-transplant Kaposi sarcoma (KS) is mainly based on 3 axes: reduction of immunosuppression, conversion to mammalian target of rapamycin (mTOR) inhibitors and/or chemotherapy. Objective: To obtain an overview of clinical strategies about the current treatment of KS. Methods: We conducted a multicenter retrospective cohort study including 145 solid organ transplant recipients diagnosed with KS between 1985 and 2011 to collect data regarding first-line treatment and response at 6 months. Results: Ninety five percent, 28% and 16% of patients had reduction of immunosuppression, conversion to mTOR inhibitor and chemotherapy, respectively. Patients treated with chemotherapy or mTOR inhibitor conversion were more likely to have visceral KS. Overall, 83% of patients had response at 6 months including 40% complete responses (CR). Limitations: The retrospective design of the study. Conclusion: Currently available therapeutic options seem to be effective to control KS in a majority of patients. Tapering down the immunosuppressive regimen remains the cornerstone of KS management.

Dermatology, 1997

Background: The incidence of Kaposi's sarcoma (KS) in patients transplanted at the Organ Transplant Center of Catholic University in Rome appears to have increased in recent years. Objective: To describe the clinical characteristics of KS in a group of transplant recipients. Methods: Over 8 years, a total of 302 renal-transplant recipients were followed. When KS was suspected, histology and staging procedures were performed. Results: Ten cases of KS have been diagnosed (8 males, 2 females; age 46.4±9.4 years); 4 of them were on triple therapy. Ali the patients were HIV-1 seronegative. The onset of KS occurred 3 months to 4 years after transplantation (21.

Journal of Cancer Research and Clinical Oncology, 2020

Background De novo malignancy is a worrying complication after kidney transplantation; the type of which may vary due to factors such as the prevalence of viral infection and race. Kaposi sarcoma used to be the most common malignancy among our patients constituting more than one-third of cancers. Nevertheless, we noticed that Kaposi sarcoma has not been observed for a long period. Therefore, we conducted this study to explore such observation. Methods Data of all kidney transplant recipients were retrieved and retrospectively analyzed. Their total number was 3126 patients. Their mean age was 28.71 ± 10.97 years and of them, 823 (26.3%) were females. The pattern of Kaposi sarcoma throughout the last decade as well as the preceding three decades was studied. The possible relation between the disappearance of Kaposi sarcoma and three paradigm shifts in our practice, namely the use of mTOR inhibitors, steroid-free regimen and CMV prophylaxis was explored. Results Since 2010, no new cases of Kaposi sarcoma have been observed. In addition, patients who have been transplanted after 2006 did not develop such malignancy. Patients who received CMV prophylaxis and/or were maintained on mTOR inhibitor or steroid-free regimens have not developed Kaposi sarcoma. Moreover, CMV prophylaxis had a statistically significant difference when compared to a homogenous group without CMV prophylaxis. However, Kaplan-Meier analysis of patients of the three policies and their counterpart groups showed comparable results. Conclusion Kaposi sarcoma, which was previously the most common malignancy, is no longer observed for almost a decade among our kidney transplant recipients. m-TOR inhibitors, steroid-free regimen and CMV prophylaxis policy are possible contributing factors. Nevertheless, only CMV prophylaxis policy had a statistically significant relation to the disappearance of Kaposi sarcoma.

Nephrology Dialysis Transplantation, 1996

New England Journal of Medicine, 2005

American Journal of Transplantation, 2002

Treatment is usually withdrawal of immunosuppression; nonresponders often receive chemotherapy. Successful treatment with single agent paclitaxel (PTX) has been documented in only one patient. We report two patients with generalized cutaneous, and visceral KS, which progressed despite withdrawal of immunosuppressive therapy, and were treated with weekly PTX. Both patients' KS regressed completely after four courses of PTX, and remained in remission for Ͼ1 year. PTX may be important in the treatment of post-transplant KS resistant to withdrawal of immunosuppressive therapy.

Background. The aim of this study was to investigate retrospectively the clinical presentation, the efficacy of reducing immunosuppression and the consequences of this therapeutic approach in Kaposi's sarcoma (KS) developing after renal transplantation. Methods. We reviewed the records of 502 patients who had been followed up at our transplantation unit between October 1, 1987 and December 30, 1998. Twelve patients (2.4%) with KS were included in the study.

International journal of dermatology, 2003

Kaposi's sarcoma (KS) in renal transplant recipients (RTRs) probably arises from a complex interplay of multiple factors. In order to analyze the prevalence of KS in patients transplanted at the Cruces Hospital in Bilbao, together with their clinical features, treatment, and etiologic factors, we performed a study using the registry of RTRs in our center. The records of 1,230 kidney transplant patients at the Cruces Hospital between 1979 and 1998 were reviewed. Immunosuppressive therapy was reduced once a diagnosis of KS was made. A nested polymerase chain reaction was used to detect human herpesvirus 8 (HHV-8) DNA in the biopsy tissue. The DNA was extracted from fresh tissue (n = 2) or from formalin-fixed, paraffin-embedded specimens (n = 5). Six cases of KS were diagnosed. All patients with cutaneous KS improved with a reduction in immunosuppressive drugs. HHV-8 was detected in 100% (2/2) of the frozen biopsies and 20% (1/5) of the formalin-fixed samples investigated. Our expe...

Cureus, 2024

Kaposi's sarcoma (KS) is a malignancy that commonly appears as lesions on the skin or mucosal surfaces but can also develop in other organs. This cancer is usually caused by the human herpesvirus 8 (HHV-8), recently known as Kaposi's sarcoma-associated herpesvirus (KSHV). KS is rare in the general population but can develop in kidney transplant recipients with varying incidence due to immunocompromised status from immunosuppression. The main aim of the present systematic review was to identify the prevalence and treatment of KS in kidney transplant patients. PubMed, Cochrane Library, and Google Scholar databases were searched for studies until October 2023. Full-text studies with similar research objectives were included, while non-English articles, reviews, case reports, ongoing clinical trials, and studies evaluating KS in HIV patients or after other solid organ transplants were excluded. All studies were observational; therefore, methodological quality was assessed using the Newcastle-Ottawa Scale. The statistical analyses were performed with the Comprehensive Meta-Analysis (CMA) software (Biostat, Inc. Englewood, NJ). The pooled analysis from the 15 studies included showed that KS develops in 1.5% of kidney transplant recipients and is more prevalent in African (1.7%) and Middle Eastern (1.7%) recipients than in Western recipients (0.07%). KS was also significantly more prevalent among male recipients than female recipients (OR: 2.36; p < 0.0001). Additionally, cyclosporine-based immunosuppression accounts for most KS incidences (79.6%) compared to azathioprine-based immunosuppression (28.2%). Furthermore, reduction or withdrawal of immunosuppression alone resulted in 47.8% KS complete remissions. Post-kidney transplantation KS is more frequent among males and patients of Middle Eastern and African origin. However, the gender difference may be attributed to most patients undergoing kidney transplants being male. Therefore, if gender balance is considered in future studies, then the difference might be insignificant. Based on our results, we can concur that the mainstay treatment for post-transplant KS is reduction or withdrawal of immunosuppression. However, the patients should be closely monitored to avoid KS recurrence and kidney rejection. Furthermore, there is an increased risk for KS with the use of cyclosporine-based immunosuppression. However, this does not mean that the withdrawal of this immunosuppression agent might result in improved KS outcomes because the withdrawal of azathioprine with or without cyclosporine reduction has also led to improved outcomes.