Kaposi's sarcoma

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Kaposi's sarcoma (KS) is a "a multicentric, malignant neoplastic vascular proliferation characterized by the development of bluish-red cutaneous nodules, usually on the lower extremities, most often on the toes or feet, and slowly increasing in size and number and spreading to more proximal areas. Kaposi's sarcoma occurs spontaneously in Jewish and Italian males in Europe and the United States. An aggressive variant in young children is endemic in some areas of Africa. A third form occurs in about 0.04% of kidney transplant patients."[1]

Since, in the United States, it was most common in older men, its appearance in a concentration of young men was one of the first clues to AIDS and its immunosuppressive effects. It is associated with the presence of human herpesvirus-8 (HHV-8), although non-immunosuppressed patients with HHV-8 rarely develop KS.

Pathology

The tumors have endothelium-lined channels and vascular spaces admixed with variably sized aggregates of spindle-shaped cells, and often remain confined to the skin and subcutaneous tissue, but widespread visceral involvement may occur.

Treatment

Standard treatment, according to the National Cancer Institute, is surgery for localized lesions, and radiotherapy both for widespread and local disease. [2] If there is an underlying immunosuppressive condition, it must be treated aggressively.

Due to the relatively low prevalence of the disease, there is less experience with antineoplastic agents and biologic response modifiers. More successful chemotherapy has used pegylated liposomal doxorubicin or liposomal daunorubicin, compared to the combination of doxorubicin, bleomycin, and vincristine[3] or bleomycin and vincristine[4].

There has been some success with interferons.[5], and early results with interleukin-12.[6]

References

  1. Anonymous (2015), Kaposi's sarcoma (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. Kaposi Sarcoma Treatment (PDQ®): Treatment - Health Professional Information [NCI], National Cancer Institute,National Institutes of Health
  3. Northfelt DW, Dezube BJ, Thommes JA, et al.: Pegylated-liposomal doxorubicin versus doxorubicin, bleomycin, and vincristine in the treatment of AIDS-related Kaposi's sarcoma: results of a randomized phase III clinical trial. J Clin Oncol 16 (7): 2445-51, 1998.
  4. Stewart S, Jablonowski H, Goebel FD, et al.: Randomized comparative trial of pegylated liposomal doxorubicin versus bleomycin and vincristine in the treatment of AIDS-related Kaposi's sarcoma. International Pegylated Liposomal Doxorubicin Study Group. J Clin Oncol 16 (2): 683-91, 1998.
  5. Real FX, Oettgen HF, Krown SE: Kaposi's sarcoma and the acquired immunodeficiency syndrome: treatment with high and low doses of recombinant leukocyte A interferon. J Clin Oncol 4 (4): 544-51, 1986
  6. Little RF, Pluda JM, Wyvill KM, et al.: Activity of subcutaneous interleukin-12 in AIDS-related Kaposi sarcoma. Blood 107 (12): 4650-7, 2006.