Tuesday, September 29, 2009

Safety and efficacy of pegylated liposomal doxorubicin in HIV-associated Kaposi's sarcoma.

Safety and efficacy of pegylated liposomal doxorubicin in HIV-associated Kaposi's sarcoma.

Department of Internal Medicine, School of Medicine, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana.

Correspondence: Francesca Cainelli, Senior Lecturer in Internal Medicine, School of Medicine, Faculty of Health Sciences, University of Botswana, Private Bag 0022, Gaborone, Botswana, Tel +267.3554563, Email, francescacainelli@yahoo.it

Kaposi's sarcoma is a vascular tumor linked to the presence of Kaposi's sarcoma-associated herpesvirus (human herpesvirus-8) and the incidence of which has increased considerably the world over after the onset of the human immunodeficiency virus (HIV) pandemic. Antiretroviral therapy combined with cytotoxic agents has been established as the treatment of choice in the past 10 years. Among chemotherapeutic agents, pegylated liposomal doxorubicin has become the preferred one for patients with HIV-associated Kaposi's sarcoma in Western countries. The drug in this formulation localizes better to the tumor and has higher efficacy. Skin toxicity, mucositis, and leukopenia/neutropenia are the main side effects. Hepatotoxicity and mild cardiotoxicity are observed less frequently. Pegylated liposomal doxorubicin impacts favorably on quality of life. Although cost effective in Western countries, the drug is less so in developing countries.

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Monday, September 21, 2009

Kaposi's sarcoma after renal transplantation.

Kaposi's sarcoma after renal transplantation.
Saudi J Kidney Dis Transpl. 2009 Sep-Oct

Abbaszadeh S, Taheri S.
Dr. Taheri Medical Research Group, Baqiyatallah University of Medical Sciences, Tehran, Iran.

In this study, we aimed to evaluate the incidence, features and outcome of post trans-plant KS among Iranian recipients of living kidney allograft. We studied 2211 kidney allograft reci-pients who underwent living renal transplantation at our center between January 1984 and August 2007. All patients in our study received cyclosporine based immunosuppressive agents. The diagno-sis of KS was confirmed with pathological evaluations of tissue biopsy specimens. There were 10 of 2211 (0.45%) incident cases of KS kidney transplant population at our center during a mean follow up of 57 +/- 38 months. Of the 10 KS patients, 8 were males and two were females with a median age of 52 years. The median time from transplantation to the development of KS was 8 months. Overall, two (20%) patients developed visceral involvement (one eye, one bladder), and eight patients mani-fested only KS restricted to the skin. Immunosuppression was reduced in 5 patients and thoroughly withdrawn in the remainder (including two cases of visceral involvement); KS did not abate in the patient with bladder involvement. All the KS patients remained alive after a mean of 35.6 +/- 39.3 months of follow up; two patients lost their allograft and underwent dialysis (one after 3 months and one another after 4 months of KS diagnosis). The KS patients were significantly older at their transplantation time (P= 0.008; [Table 1]). Survival analysis using Kaplan Meier method and log-rank test revealed no difference in graft and patient survival between both groups. In conclusion, we found low incidence of KS in our living renal transplant recipients. The outcome of the KS patients was excellent with low morbidity and mortality. The incidence of KS was significantly associated with an older age at transplantation time for the allograft recipients. Further studies with larger pa-tient population are warranted to confirm our results.

Saudi Journal of Kidney Diseases and Transplantation

Thursday, September 17, 2009

Classic Kaposi sarcoma with sarcoid-like granulomas: A case report and literature review.

Classic Kaposi sarcoma with sarcoid-like granulomas: A case report and literature review.
Exp Mol Pathol. 2009 Aug

Onak Kandemir N, Yurdakan G, Bektas S, Tekin NS.
Department of Pathology, School of Medicine, Zonguldak Karaelmas University, 67600, Kozlu, Zonguldak, Turkey.

The occurrence of granulomatous reactions within lymph nodes that drain carcinomas is well known but uncommon. Even more rarely, granulomas may occur within the stroma of tumors. These lesions, called sarcoid-like reactions, commonly accompany carcinomas but are very rare in sarcomas. This study presents a case of classic Kaposi sarcoma that contained sarcoid-like granulomas, with a literature review. A soft tissue lesion of the foot was excised from a 74-year-old male. Histopathological examination showed that the tumor tissue consisted of spindle cells, areas of atypical vascular proliferation, and extravasated erythrocytes surrounded by non-caseating granulomas. The patient had no clinical or laboratory findings of sarcoidosis. The case was interpreted as "Kaposi sarcoma containing sarcoid-like granulomas". The association of soft tissue sarcomas with a granulomatous reaction is very rare. A granulomatous reaction is reported to be a good prognostic indicator in several carcinoma types, although its importance in sarcomas is unclear.

Elsevier/Science Direct

Clinical Presentation of Non-HIV Kaposi Sarcoma.

Clinical Presentation of Non-HIV Kaposi Sarcoma.

J Coll Physicians Surg Pak. 2009 Sep

Gilani JA, Ullah Khan A, Shahid S, Ullah Khan I, Ullah Khan S.
Department of Radiotherapy and Oncology, (IRNUM), Peshawar.

Kaposi Sarcoma (KS) is a rare entity. In the north west of Pakistan and Aghanistan, we mostly come across non-HIV related Kaposi sarcoma as Human Immunedeficiency Virus (HIV). Infections are rare in this part of the world. Here, we present a case of a non-auto Immunedeficiency Disease (AIDS) related KS. A 45-year-old male, Afghan patient presented to our oncology outpatient's unit with multiple subcutaneous nodules. The sites of involvement were the periorbital region, retro-auricular region, forearms, legs, chest and back. Oral mucosa was spared at the nodules. The patient had no visceromegaly at the time of presentation. A biopsy specimen from the retro-auricular region revealed a KS with dermal lymphatic involvement. His serum was negative for the common types of viral infections including Human Immunodeficiency Virus (HIV) on routine serology. His total B-lymphocytes (CD 19+), total T-lymphocyte (CD3+), total CD4+ lymphocyte (CD3+, CD4+) and total CD8+ (CD3+, CD8+) counts were all normal or borderline high. The patient was under treatment with 3 weekly chemotherapeutic regimens of Adriamycin, Bleomycin, Vincristine (ABV) keeping in view socioeconomical constrains, logistical difficulties in getting proper medical care and side effects of other options like radiotherapy for extended surface areas.