Kaposi sarcoma in a patient treated with ruxolitinib

Iatrogenic Kaposi's sarcoma in a myelofibrosis patient treated with ruxolitinib: Case‐report, literature review, and French pharmacovigilance data

“…5 In this series of cases, only two patients had CD4 assessment at KS diagnosis; one had a very low CD4 cell count (32/μL), and the other had a CD4 cell count at 412/μL. 3 The median time from ruxolitinib initiation to KS diagnosis was 2.2 years (range 9 months to 7 years). The impairment of natural killer (NK) cell function by ruxolitinib could also explain the increasing risk of viral infections.…”

“…To identify articles reporting KS in patients receiving ruxolitinib, we searched the PubMed database using the equation "ruxolitinib" AND "Sarcoma, In addition to the case presented here, three other cases have been described in the literature since 2017 and one patient was reported in the FPVD in 2018. [2][3][4] The main characteristics of the five patients are presented in Table 1 and the other with complete remission 4 months after discontinuation, associated with surgical resection and intralesional vincristine. 3,4 KS-related death was observed in two patients; in one case, at 1 month after ruxolitinib discontinuation, and in the other, at 5 months after discontinuation, despite specific treatment with radiotherapy and paclitaxel.…”

“…[2][3][4] The main characteristics of the five patients are presented in Table 1 and the other with complete remission 4 months after discontinuation, associated with surgical resection and intralesional vincristine. 3,4 KS-related death was observed in two patients; in one case, at 1 month after ruxolitinib discontinuation, and in the other, at 5 months after discontinuation, despite specific treatment with radiotherapy and paclitaxel. One patient died 4 months after ruxolitinib discontinuation due to cytopenia and kidney damage; no improvement in the KS lesions was observed in that patient.…”

“…Several other opportunistic infections, such as HBV reactivation, EBV-associated lymphoproliferative disorders, VZV meningo-encephalitis, CMV retinitis, multifocal progressive leukoencephalopathy, pneumocystis, and tuberculosis have previously been reported. [2][3][4] Salivary and sexual transmissions are the major modes of KSHV transmission. 1 However, KSHV could also be transmitted through transplantation of infected organs and blood transfusion, although systematic leucocyte-depletion of red blood cell units reduces the risk of transmission.…”

Drug-Related Cutaneous Adverse Events in Philadelphia Chromosome-Negative Myeloproliferative Neoplasms: A Literature Review

“…Dasanu presented an uncommon case of erythematous skin eruption with necrotic foci that involved the lower extremities in a patient with MF who was treated with ruxolitinib [19]. Loscocco et al presented a case of Kaposi sarcoma (KS) in a patient who was enrolled in a phase 2 trial of ruxolitinib in PV or essential thrombocythemia (ET) that was refractory or intolerant to HU [23]. Ruxolitinib was discontinued by tapering over 2 weeks, after which progressive spontaneous regression of cutaneous lesions was achieved that largely resolved within 10 months.…”