Sirolimus for the Treatment of Kaposi Sarcoma After Renal Transplantation: A Series of 10 Cases

Yaïch, S.; Charfeddine, K.; Zaghdane, S; Aoud, N. El; Jarraya, F.; Kharrat, M.; Hachicha, J.

doi:10.1016/j.transproceed.2012.09.025

Cited by 65 publications

(28 citation statements)

References 11 publications

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“…44 At least three separate clinical studies have reported 100% tumor regression of cutaneous Kaposi's sarcoma lesions following conversion from CNIs to sirolimus in kidney transplant recipients, with no apparent loss of graft function. [45][46][47] The mechanisms by which mTOR inhibitors mediate Kaposi's sarcoma regression remain unclear; however, recent studies suggest that rapamycin may reduce the formation of tumor vasculature by reducing VEGF secretion, 48 and may also directly interfere with HHV-8 virus replication. 49 Based on these findings, it may seem logical to switch all patients at increased risk of cancer on CNIs to sirolimus.…”

Section: Altering the Immunosuppression Regime Alters Nmsc Outcomementioning

confidence: 99%

Does the nature of residual immune function explain the differential risk of non‐melanoma skin cancer development in immunosuppressed organ transplant recipients?

Jung

Overgaard

Burke

et al. 2015

Intl Journal of Cancer

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Patients receiving immunosuppression to prevent organ transplant rejection are at a greatly increased risk of developing nonmelanoma skin cancer. In recent years a correlation has been identified between the class of immunosuppressant that these patients receive and their subsequent cancer risk; in particular, patients switched from calcineurin inhibitors to mammalian target of rapamycin (mTOR) inhibitors not only displayed a dramatic reduction in new tumor formation but also in some cases a regression of their existing lesions. Studies of cancer models in mice and cell lines in the laboratory have attributed these discrepancies in cancer risk to the ability of immunosuppressants such as mTOR inhibitors to elicit direct anticancer effects, including suppressing angiogenesis and increasing autophagy‐mediated DNA repair. Recent evidence from the immunological literature however, suggests a significant alternative contribution of mTOR inhibitors; namely the promotion of memory T‐cell function. Recent advances in understanding memory T‐cell establishment and the demonstration of their critical role in long‐term immunity make it timely to review the available evidence as to whether the improved nonmelanoma skin cancer outcome shown by patients switched to mTOR inhibitor treatment regimens may be associated with the retainment of memory T‐cell function.

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Section: Altering the Immunosuppression Regime Alters Nmsc Outcomementioning

confidence: 99%

Does the nature of residual immune function explain the differential risk of non‐melanoma skin cancer development in immunosuppressed organ transplant recipients?

Jung

Overgaard

Burke

et al. 2015

Intl Journal of Cancer

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“…An increased prevalence of Kaposi's sarcoma among solid organ transplant patients is well documented . In this setting, the sarcoma manifests particularly as cutaneous disease, but can rarely involve the GI tract . By contrast, Kaposi's sarcoma rarely develops among HSCT patients .…”

Section: Neoplasiamentioning

confidence: 99%

“…43,67,68 In this setting, the sarcoma manifests particularly as cutaneous disease, 67 involve the GI tract. 69 By contrast, Kaposi's sarcoma rarely develops among HSCT patients. 68 Solid organ transplant patients also show an increased predisposition for human papilloma virus-associated neoplasms, such as anal squamous cell carcinoma.…”

Section: O T H E R N E O P L a S M Smentioning

confidence: 99%

Gastrointestinal pathology in transplant patients

Wong

2014

Histopathology

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The assessment of gastrointestinal (GI) specimens from transplant patients is complicated by the wide range of potentially rare pathologies that may be found in this clinical setting. Acute GI graft-versus-host disease (GvHD) is characterized by epithelial cell apoptosis, although there is increasing recognition that acute and/or chronic inflammation may also be present. By contrast, thus far there are no histological features known to be specific to chronic GI GvHD. Mycophenolate mofetil colitis may mimic both GvHD and inflammatory bowel disease, whereas both cytomegalovirus (CMV) and adenovirus infections can cause gland apoptosis. Post-transplant lymphoproliferative disorder should be considered if a Crohn's-like histological picture is seen, and granulomas in biopsies from umbilical cord blood recipients should raise a suspicion of cord colitis syndrome. Finally, the GI tract may be involved directly or indirectly by the disease that originally required haematopoietic stem cell or liver transplantation.

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“…Chemotherapy including single‐agent liposomal anthracyclines (doxorubicin and daunorubicin) and single‐agent paclitaxel has been used, especially in advanced or visceral KS . Finally, mTOR inhibitors are an option in transplant recipients since they have anti‐proliferative properties that may be useful in the treatment of KS and other angiogenic proliferative diseases . Because of the advanced stage of KS in our patient, we stopped all immunosuppression except for a small dose of prednisone, and initiated chemotherapy with liposomal doxorubicin, with the option to introduce sirolimus after completion of chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

An unusual case of Kaposi sarcoma masquerading as cystitis in a kidney transplant recipient

Nair

Sheikh

Hirschwerk

et al. 2019

Transplant Infectious Dis

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Sirolimus for the Treatment of Kaposi Sarcoma After Renal Transplantation: A Series of 10 Cases

Cited by 65 publications

References 11 publications

Does the nature of residual immune function explain the differential risk of non‐melanoma skin cancer development in immunosuppressed organ transplant recipients?

Does the nature of residual immune function explain the differential risk of non‐melanoma skin cancer development in immunosuppressed organ transplant recipients?

Gastrointestinal pathology in transplant patients

An unusual case of Kaposi sarcoma masquerading as cystitis in a kidney transplant recipient

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