Kaposi's sarcoma in renal transplant patients: experience at the Cruces Hospital in Bilbao

Mitxelena, J.; Gómez-Ullate, P; Aguirre, A.; Rubio, G; Lampreabe, I; Díaz‐Pérez, J.L.

doi:10.1046/j.1365-4362.2003.01636.x

Cited by 15 publications

(6 citation statements)

References 29 publications

(39 reference statements)

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“…This includes (i) Classic KS, a disease that mainly affects elderly Mediterranean men, (ii) iatrogenic KS, which develops in patients taking immunomodulatory agents in the context of solid-organ transplantation, and (iii) AIDS-related KS. (5-7) African-KS is endemic to Africa and unrelated to HIV infection. KSHV infection and an ineffective host immune response towards this gamma herpes virus are common to all of the aforementioned KS clinical subtypes.…”

Section: Major Clinical Characteristicsmentioning

confidence: 99%

Targeted Therapy for Kaposi Sarcoma

2009

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Kaposi sarcoma (KS) occurs as a result of Kaposi sarcoma-associated virus (KSHV) infection, typically in the context of one of several immunodeficient states. In the United States, patients with KS may either be co-infected with human immunodeficiency virus (HIV) or on immunosuppressant therapy following solid-organ transplantation. Systemic treatment of KS traditionally involved one of several chemotherapeutic agents either in combination or as single agents, which typically provides reasonable response rates and short term control. However recurrence is common and progression free intervals are under one year. For these reasons, new therapies have been sought and with the elucidation of novel pathogenic mechanisms of KS, rationale targets identified. These include KSHV replication, restoration of immune competence, and signal transduction pathways utilized by KSHV in the propagation of KS.

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Section: Major Clinical Characteristicsmentioning

confidence: 99%

Targeted Therapy for Kaposi Sarcoma

2009

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“…One hundred twenty‐three abstracts were excluded due to one or more of the following characteristics: a pediatric age group, fewer than 100 subjects; and review type article, case series, clinical trials, or studies of therapy or survival after diagnosis of a post‐transplant neoplasm. A total of 64 studies were reviewed in full text and analyzed in more detail (5, 7–69).…”

Section: Resultsmentioning

confidence: 99%

Epidemiologic critique of literature on post‐transplant neoplasms in solid organ transplantation

Lanza

Wang

Simon

et al. 2009

Clinical Transplantation

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As survival of transplant recipients improves, long-term complications become more important. We reviewed epidemiologic literature on real-world risks of de novo neoplasia post-transplant. We searched the Medline/PubMed, Cochrane, and Embase databases for population-based studies on risk of neoplasia from 1998 to 2005. Selection criteria included: solid organ transplants, neoplastic outcomes, n > 500 subjects, age > or = 18 yr, and study design. Of 187 abstracts, 64 met criteria for study size, age range, topic, and design. We classified the articles by quality of reporting on components of cohort studies. Twelve of 64 studies reported cohort eligibility and exclusion criteria, defined time at risk, and ascertained incident neoplasms. Twenty-one studies reported prevalence of neoplasms for unspecified time periods, and only eight incidence studies reported person yr at risk. Three studies of all types of neoplasms in kidney recipients reported incidence ranging from 11.0 to 17.3 cases per 1000 person yr. Two studies of post-transplant lymphoproliferative disorders reported incidence of 0.4 to 2.5 cases per 1000 person yr in kidney recipients. More precise estimation of risks and rates, better description of study population, and more attention to confounding in comparisons of rates would make studies more meaningful. Reports should adhere to established guidelines for presenting methods and results in epidemiologic studies.

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“…The lesion is 400e500 times more common among transplant patients than among the general population, afflicting 1 out of 200 transplant patients in the United States (Harwood et al, 1979). In this group of patients, immunosuppressive therapy plays a major role in the development of the lesion (Mitxelena et al, 2003) that is known as iatrogenic KS (Trattner et al, 1993).…”

Section: Discussionmentioning

confidence: 99%