Kaposi’s sarcoma: Good outcome with doxorubicin, bleomycin and vincristine sulphate (ABV) chemotherapy and highly active antiretroviral therapy

Abstract

There is little published information on effective treatment of Kaposi's sarcoma (KS) in children in low-income countries. We prospectively treated 12 patients with an institutional review board-approved protocol consisting of four monthly courses of doxorubicin (Adriamycin), bleomycin and vincristine sulphate (ABV), with highly active antiretroviral therapy (HAART) plus co-trimoxazole prophylaxis for those who were HIV-positive, with additional vincristine if remission was not achieved after 4 months. Maintenance HAART plus co-trimoxazole was given to all HIV-positive patients. A fine-needle aspirate and CD4+ count were done if possible, and staging was performed according to Mitsuyasu. Eight of ten HIV-positive patients with stage III - IVB disease, and both HIV-negative patients with stage I disease, were in remission after 473 - 1 490 (mean 939) days. One patient died after absconding during treatment, and one died from neutropenia-related pulmonary infection. ABV with or without HAART is an effective treatment option for children with KS.

Two decades of childhood cancer care in Cameroon: 2000–2020

“…Two of the reports addressed awareness, 7,11 10 addressed diagnosis, registration, and epidemiology, 5,[12][13][14][15][16][17][18][19][20] 18 addressed management and outcomes, 7,14,16,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] four addressed supportive care, [36][37][38][39] five addressed palliative care, [40][41][42][43][44] four addressed advocacy and F I G U R E 1 Map of Cameroon showing location of dedicated pediatric oncology units partnerships, 35,37,45,46 and one addressed T&CM 39 (Supporting Information File S1).…”

“…Two of the reports addressed awareness, 7,11 10 addressed diagnosis, registration, and epidemiology, 5,12–20 18 addressed management and outcomes, 7,14,16,21–35 four addressed supportive care, 36–39 five addressed palliative care, 40–44 four addressed advocacy and partnerships, 35,37,45,46 and one addressed T&CM 39 (Supporting Information File S1).…”

“…Outcomes vary by disease and are usually under pressure of difficult access to essential cancer medicines, late diagnosis, and lack of registries 7,21 . Results regarding survival are fragmentary, but do indicate improved survival, especially for BL and nephroblastoma 14,16,23,26,28,52 . Proper follow‐up is essential for measuring outcomes, and the CBCHS centers keep both paper‐based and electronic records at dedicated childhood cancer registry offices at MBH, BBH, and BHM.…”

“…34 The CBCHS pediatric oncology units collaborated in the Collabora- and highly active ART (HAART). 28 A 5-year patient survival rate of 82% has been reported for a cohort of 26 patients with Hodgkin disease. 27…”

“…7,21 Results regarding survival are fragmentary, but do indicate improved survival, especially for BL and nephroblastoma. 14,16,23,26,28,52 Proper follow-up is essential for measuring outcomes, and the CBCHS centers keep both paper-based and electronic records at dedicated childhood cancer registry offices at MBH, BBH, and BHM. Additional follow-up has been done by means of outreaches and by using mobile phones to establish specific outcomes.…”