Kaposi’s Sarcoma as Manifestation of Immunosuppression in Organ Transplant Recipients

Aebischer, Maude; Zala, L; Braathen, Lasse R.

doi:10.1159/000245703

Cited by 14 publications

(9 citation statements)

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“…Four clinico-epidemiological variants are currently distinguished: classic KS, African-endemic KS, epidemic KS associated with acquired immunodeficiency syndrome and iatrogenic KS [1]. This last subtype has been reported in patients treated with diverse immunosuppressant drugs such as corticosteroids, azathioprine, cyclosporine A or mycophenolate mofetil by diverse medical entities, though essentially as a consequence of immunosuppression after solid organ transplantation [2,3,4]. …”

Section: Introductionmentioning

confidence: 99%

Posttransplant Kaposi’s Sarcoma Restricted to the Site of a Previous Deep Venous Thrombosis: Abrupt Onset after Withdrawal of Sirolimus

González‐López

Rodrigo²,

González‐Vela³

et al. 2006

Dermatology

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Kaposi’s sarcoma (KS) is an angioproliferative neoplasia associated with human herpesvirus 8 (HHV-8) infection. HHV-8 generates KS by means of the secretion of vascular endothelial growth factor (VEGF) andup-regulation of VEGF receptor, KDR, in endothelial cells. We report a case of KS in a 72-year-old male with a renal transplant who had received immunosuppressant drugs including sirolimus, mycophenolate mofetil, tacrolimus and steroids. KS developed 11 months after transplantation, in relation to deep venous thrombosis and withdrawal of sirolimus due to toxicity. Multiple purple papules and nodules were observed exclusively in the limb affected by thrombosis. Diagnosis of KS was confirmed by biopsy. Progressive withdrawal of prednisone was accompanied by full remission of the tumour. The thrombosis and withdrawal of sirolimus may have acted as cofactors in the development of KS, favouring the activation of the VEGF/KDR autocrine loop. Our experience contributes to further evidence that sirolimus may protect against KS.

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Section: Introductionmentioning

confidence: 99%

Posttransplant Kaposi’s Sarcoma Restricted to the Site of a Previous Deep Venous Thrombosis: Abrupt Onset after Withdrawal of Sirolimus

González‐López

Rodrigo²,

González‐Vela³

et al. 2006

Dermatology

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“…The occurrence of KS among transplant recipients is associated with immunosuppressive therapy (particularly calcineurin inhibitors), as evidenced by several reports describing the remission of KS lesions following the reduction or withdrawal of the immunosuppressive therapy [8][9][10][11][12]. Immunosuppression is known to result in the reactivation of many human herpesviruses, including herpes simplex virus types 1 and 2, cytomegalovirus, Epstein-Barr virus, varicella-zoster virus, and HHV-6 [1].…”

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confidence: 99%

Reactivation of and Primary Infection with Human Herpesvirus 8 among Solid‐Organ Transplant Recipients

2002

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Human herpesvirus 8 (HHV-8) is the causal agent of all forms of Kaposi's sarcoma, including the iatrogenic form that presents in solid-organ transplant recipients. A longitudinal study of HHV-8 seropositivity was conducted among a cohort consisting of children and adult solid-organ transplant recipients. Antibodies to HHV-8 lytic proteins were detected by an indirect immunofluorescence assay in serum samples of 100 transplant recipients. HHV-8 seropositivity increased significantly, from 5.3% before transplantation to 15.8% after transplantation (P<.01). Seropositivity was not related to the age of the patient or the type of organ transplanted. HHV-8 seroconversion occurred in both children and adult recipients. None of the seroconversion events was related to the source of the donor organ. These findings suggest that HHV-8 infection is not uncommon among both adult and children transplant recipients and that viral infection may be acquired from an outside source other than the transplanted organ.

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“…Persistent disseminated cutaneous disease, or visceral KS, require systemic therapy. Other groups have reported the results of chemotherapy in 23 such patients (12–18). All of those whose KS was limited to the skin responded completely to a variety of regimens, and survived.…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Post-Renal Transplant Kaposi’s Sarcoma with Paclitaxel

Patel

Salifu²,

Sumrani

et al. 2002

American Journal of Transplantation

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Kaposi's sarcoma (KS) is a complication of immunosuppressive therapy for renal transplant recipients.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.

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Kaposi’s Sarcoma as Manifestation of Immunosuppression in Organ Transplant Recipients

Cited by 14 publications

References 0 publications

Posttransplant Kaposi’s Sarcoma Restricted to the Site of a Previous Deep Venous Thrombosis: Abrupt Onset after Withdrawal of Sirolimus

Posttransplant Kaposi’s Sarcoma Restricted to the Site of a Previous Deep Venous Thrombosis: Abrupt Onset after Withdrawal of Sirolimus

Reactivation of and Primary Infection with Human Herpesvirus 8 among Solid‐Organ Transplant Recipients

Successful Treatment of Post-Renal Transplant Kaposi’s Sarcoma with Paclitaxel

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