Management of Kaposi sarcoma after solid organ transplantation: A European retrospective study

JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY

卷:81

Article

Delyon, Julie¹  Rabate, Clementine^2,3  Euvrard, Sylvie⁴  Harwood, Catherine A.⁵  Proby, Charlotte⁶  Gulec, Tulin⁷  Seckin, Deniz⁷  Del Marmol, Veronique⁸  Bouwes-Bavinck, Jan Nico⁹  Ferrandiz-Pulido, Carla¹⁰  Ocampo, Maria Andrea^4,16  Barete, Stephane¹¹  Legendre, Christophe^2,3  Frances, Camille¹²  Porcher, Raphael^13,14,15  Lebbe, Celeste¹ 

[1] Univ Paris Diderot, Hop St Louis, AP HP, Dept Dermatol,INSERM,Sorbonne Paris Cite,U976, Paris, France

[2] Hop Necker Enfants Malad, AP HP, Serv Nephrol Transplantat Adultes, Paris, France

[3] Univ Paris 05, Paris, France

[4] Hosp Civils Lyon, Edouard Herriot Hosp, Dept Dermatol, Lyon, France

[5] Queen Mary Univ London, Ctr Cell Biol & Cutaneous Res, Blizard Inst, Barts & London Sch Med & Dent, London, England

[6] Univ Dundee, Dermatol, Sch Med, Dundee, Scotland

[7] Baskent Univ, Dept Dermatol, Fac Med, Ankara, Turkey

[8] Univ Libre Bruxelles, Erasme Hosp, Dermatol, Brussels, Belgium

[9] Leiden Univ, Med Ctr, Dept Dermatol, Leiden, Netherlands

[10] Hosp Univ Vall dHebron, Dept Dermatol, Barcelona, Spain

[11] Sorbonne Univ, Pitie Salpetriere Hosp, AP HP, Unit Dermatol, Paris, France

[12] Sorbonne Univ, Hop Tenon, AP HP, Serv Dermatol & Allergol, Paris, France

[13] Hop Hotel Dieu, AP HP, Ctr Epidemiol Clin, Paris, France

[14] INSERM, U1153, Ctr Res Epidemiol & Stat CRESS, Paris, France

[15] Univ Paris 05, Sorbonne Paris Cite, Paris, France

[16] Sanitas Fdn, Dermatol Dept, Colsanitas Clin, Bogota, Colombia

关键词: chemotherapy;    immunosuppression;    Kaposi sarcoma;    mTOR inhibitor;    organ transplantation;    post-transplant malignancies;   

DOI  :  10.1016/j.jaad.2019.03.028

来源: Elsevier

【 摘 要 】

Background: Systemic therapeutic management of post-transplant Kaposi sarcoma (KS) is mainly based on 3 axes: reduction of immunosuppression, conversion to mammalian target of rapamycin (mTOR) inhibitors, chemotherapy, or a combination of these. Objective: To obtain an overview of clinical strategies about the current treatment of KS. Methods: We conducted a multicenter retrospective cohort study including 145 solid organ transplant recipients diagnosed with KS between 1985 and 2011 to collect data regarding first-line treatment and response at 6 months. Results: Overall, 95%, 28%, and 16% of patients had reduction of immunosuppression, conversion to mTOR inhibitor, and chemotherapy, respectively. Patients treated with chemotherapy or mTOR inhibitor conversion were more likely to have visceral KS. At 6 months, 83% of patients had response, including 40% complete responses. Limitations: The retrospective design of the study. Conclusion: Currently available therapeutic options seem to be effective to control KS in most patients. Tapering down the immunosuppressive regimen remains the cornerstone of KS management.

【 授权许可】

Free