Simultaneous Kaposi's sarcoma and Castleman's disease in a HIV-negative patient. Response to rituximab and doxorubicin

Calle-Primo, Carmen; Martín-Dávila, Francisco

doi:10.1016/j.medcli.2019.09.013

Cited by 1 publication

(1 citation statement)

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“…42 Integrated approaches combining RTX and chemotherapy are currently favored in MCD management, as they limit KS flaring. 36,43,44 RTX employment for indications other than MCD, such as diffuse large B-cell lymphoma, 45,46 also led to KS development in some case reports.…”

Section: Rituximabmentioning

confidence: 99%

Kaposi's sarcoma, biologics and small molecules: Navigating the complex interplay between host immunity and viral biology. A case series with focused review of the literature

Brambilla

Maronese

Zelin

et al. 2021

Dermatologic Therapy

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The consequences of cytokine-specific immune modulation in the development and course of Kaposi's sarcoma (KS) are poorly understood. A retrospective chart review of patients treated with biologic/small molecule drugs and followed at the dedicated KS outpatient service of our Dermatology Unit was performed. The literature on biologic and small molecule drug use in KS patients was also reviewed. Data concerning 12 KS patients treated with biologic/small molecule drugs were collected. After a median delay of 6 months following biologic or small molecule drug introduction, nine patients experienced either KS onset or reactivation. Drugs associated with KS onset or flaring were: rituximab, infliximab, ruxolitinib apremilast (1), mirikizumab, abatacept (1). After a median follow-up of 25 months, all cases achieved persistent complete response through culprit drug discontinuation or drug withdrawal plus treatment. No effect on KS course was recorded with tocilizumab and vedolizumab.Based on our experience with the largest case series reported to date as well as the available literature, tocilizumab and ustekinumab seem to exert an overall neutral effect on KS. On the other hand, rituximab, infliximab, and ruxolitinib have been associated with the development or worsening of pre-existing KS and should be carefully pondered before use. Due to limited and partly controversial evidence, no definitive conclusions can be drawn on vedolizumab, apremilast, mirikizumab, abatacept.

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