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Inicio Medicina Clínica (English Edition) Posttransplant Kaposi sarcoma: Analysis of a series of 13 patients
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Vol. 157. Issue 7.
Pages 339-343 (October 2021)
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Vol. 157. Issue 7.
Pages 339-343 (October 2021)
Clinical report
Posttransplant Kaposi sarcoma: Analysis of a series of 13 patients
Sarcoma de Kaposi en pacientes trasplantados: análisis de una serie de 13 casos
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Carlos González-Cruza,b, Carla Ferrándiz-Pulidoa,b,
Corresponding author
40879cfp@comb.cat

Corresponding author.
, Berta Ferrer Fàbregasa,b, Vicente García-Patos Brionesa,b
a Dermatology Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain
b Universitat Autónoma de Barcelona, Barcelona, Spain
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Table 1. Clinical features, treatment and evolution of our patients with posttransplant KS.
Abstract
Introduction and objectives

This study reflects our experience in the management of posttransplant Kaposi Sarcoma (KS) and assesses the clinical relevance of monitoring HHV-8 DNA viral load in peripheral blood by qPCR.

Patients and methods

Retrospective study of all patients diagnosed with posttransplant KS during the period 1995–2019. In 8 patients, we performed a qPCR in serum for HHV-8 DNA detection at diagnosis and/or during follow-up.

Results

Data from 13 organ transplant recipients with a diagnosis of iatrogenic KS were collected. Reduction and/or discontinuation of one or more immunosuppressive agent(s) along with switching to an mTOR inhibitor was part of the treatment approach in 12 (92%) patients. Overall response rate (including complete response, partial response, and stable disease) was observed in 9 patients. At diagnosis, HHV-8 qPCR in serum was positive in 2 out of 5 patients. During follow-up, both positive cases turned negative, as a clinical response.

Conclusions

Our work highlights the critical role of reduction of immunosuppression and conversion to an mTOR inhibitor in the management of posttransplant KS.

Keywords:
Solid-organ transplant recipient
Human Herpesvirus 8
Immunosuppression
Kaposi sarcoma
mTOR inhibitor
Post-transplant malignancies
Resumen
Introducción y objetivos

Este estudio aporta nuestra experiencia en el manejo del sarcoma de Kaposi (SK) en pacientes trasplantados, y evalúa la relevancia clínica de la monitorización por qPCR de la carga viral del VHH-8 en sangre periférica.

Pacientes y métodos

Estudio retrospectivo de los pacientes diagnosticados de SK postrasplante en el periodo de 1995-2019. En 8 pacientes, realizamos qPCR en suero para la detección de ADN del VHH-8 en el momento del diagnóstico o durante el seguimiento.

Resultados

Se recogieron datos de 13 trasplantados de órgano sólido con diagnóstico de SK. La reducción o discontinuación de uno o más fármacos inmunosupresores junto con el cambio a un inhibidor de mTOR constituyó una parte del tratamiento en 12 (92%) pacientes. Se observó respuesta al tratamiento (incluyendo respuesta completa, parcial o estabilidad) en 9 pacientes. En el diagnóstico, la qPCR en suero de VHH-8 fue positiva en 2 de 5 pacientes. Durante el seguimiento, ambos casos positivos se negativizaron al responder los pacientes al tratamiento.

Conclusiones

Nuestro trabajo muestra el papel esencial de la reducción de la inmunosupresión y la conversión a un inhibidor de mTOR en la estrategia terapéutica de SK en pacientes trasplantados.

Palabras clave:
Receptores de un trasplante de órgano sólido
Herpes virus humano 8
Inmunosupresión
Sarcoma de Kaposi
Inhibidor de mTOR
Neoplasias postrasplante

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