Treatment of Kaposi's sarcoma after solid organ transplantation

Frances A. Shepherd, Elizabeth Maher, Carl Cardella, Edward Cole, Paul Greig, Judith A. Wade, Gary Levy

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Abstract

Purpose: This retrospective review of all patients who developed Kaposi's sarcoma (KS) after solid organ transplantation at a single institution was undertaken to define the clinical presentation of this malignancy in the setting of iatrogenic immunodeficiency, and to determine the most appropriate treatment for patients in this clinical setting. Materials and Methods: The records of 2,099 patients who underwent heart, lung, liver, or kidney transplantation of The Toronto Hospital between January 1, 1981 and June 30, 1995, were reviewed. Twelve patients were identified who developed biopsy-proven KS in the posttransplantation period. Five patients who had disseminated KS who had not responded to either reduction or withdrawal of immunosuppression or to local radiotherapy were treated with combination chemotherapy consisting of doxorubicin 20 to 30 mg/m2, bleomycin 10 mg/m2, and vincristine 2 mg (ABV) administered intravenously every 3 weeks. Results: Eight of 12 patients were male and nine were of Italian origin. KS was limited to a localized area of the skin for only six patients, all after kidney transplantation. Visceral KS was present in three patients. Four of five patients responded to ABV chemotherapy (two complete and two partial remissions). The fifth patient responded to second- line etoposide and cisplatin. The median duration of response was in excess of 13 months (range, 8+ to 45+ months). Toxicity was limited to grade 1 neurotoxicity and grade 1 skin toxicity. Conclusion: KS is an uncommon but recognized complication of solid organ transplantation. Combination chemotherapy is a safe and effective treatment for patients with disseminated or visceral KS that fails to respond to changes in immunosuppression.

Original languageEnglish (US)
Pages (from-to)2371-2377
Number of pages7
JournalJournal of Clinical Oncology
Volume15
Issue number6
StatePublished - Jun 1997

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Kaposi's Sarcoma
Organ Transplantation
Therapeutics
Combination Drug Therapy
Kidney Transplantation
Immunosuppression
Heart-Lung Transplantation
Skin
Bleomycin
Vincristine
Etoposide
Liver Transplantation
Doxorubicin
Cisplatin
Radiotherapy
Biopsy
Drug Therapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Shepherd, F. A., Maher, E., Cardella, C., Cole, E., Greig, P., Wade, J. A., & Levy, G. (1997). Treatment of Kaposi's sarcoma after solid organ transplantation. Journal of Clinical Oncology, 15(6), 2371-2377.

Treatment of Kaposi's sarcoma after solid organ transplantation. / Shepherd, Frances A.; Maher, Elizabeth; Cardella, Carl; Cole, Edward; Greig, Paul; Wade, Judith A.; Levy, Gary.

In: Journal of Clinical Oncology, Vol. 15, No. 6, 06.1997, p. 2371-2377.

Research output: Contribution to journalArticle

Shepherd, FA, Maher, E, Cardella, C, Cole, E, Greig, P, Wade, JA & Levy, G 1997, 'Treatment of Kaposi's sarcoma after solid organ transplantation', Journal of Clinical Oncology, vol. 15, no. 6, pp. 2371-2377.
Shepherd FA, Maher E, Cardella C, Cole E, Greig P, Wade JA et al. Treatment of Kaposi's sarcoma after solid organ transplantation. Journal of Clinical Oncology. 1997 Jun;15(6):2371-2377.
Shepherd, Frances A. ; Maher, Elizabeth ; Cardella, Carl ; Cole, Edward ; Greig, Paul ; Wade, Judith A. ; Levy, Gary. / Treatment of Kaposi's sarcoma after solid organ transplantation. In: Journal of Clinical Oncology. 1997 ; Vol. 15, No. 6. pp. 2371-2377.
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