Childhood Kaposi's sarcoma: Clinical features and therapy

Olweny, Charles L. M.; Kaddumukasa, A; Atine, I; Owor, R; Magrath, I. T.; Ziegler, John L.

doi:10.1038/bjc.1976.88

Cited by 59 publications

(25 citation statements)

References 6 publications

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“…7 Durable responses were seen in all varieties of KS, including childhood lymphadenopathic forms. 28 Similar combinations that substitute adriamycin for actinomycin-D (ABV) in HIVassociated Kaposi's sarcoma have produced high response rates and are regarded by some investigators as the first-line treatment for patients with life-threatening or visceral disease. 25,29 However, several recent studies comparing ABV combination with liposomal doxorubicin or daunorubicin revealed that the liposomal doxorubicin/ daunorubicin was significantly more efficacious in providing objective responses and therefore is now considered by some as first-line therapy for advanced Kaposi's sarcoma.…”

Section: Discussionmentioning

confidence: 99%

Treatment of AIDS-associated Kaposi's sarcoma in Zimbabwe: Results of a randomized quality of life focused clinical trial

Olweny¹,

Borok

Gudza

et al. 2004

Int. J. Cancer

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Kaposi's sarcoma is currently the most common tumor in Zimbabwe. The purpose of our study is to compare the effectiveness of supportive care vs. 3 intervention approaches, namely oral Etoposide, a 3-drug combination, and radiotherapy using quality of life (QOL) as the primary measure of success. In addition, our study was to determine whether a disease-specific module has greater sensitivity to group differences than a generic QOL questionnaire and to determine the most pragmatic approach to treating epidemic Kaposi's sarcoma (EKS) in Zimbabwe. In addition, on the physical and psychological subscales, the Etoposide group had a significantly better QOL than the other 3 treatment groups (p < 0.04). The 3-drug combination, supportive care and radiotherapy groups did not differ significantly from each other with respect to the total FLI-C score or its subscales. There were no group differences with respect to survival. Oral Etoposide therapy resulted in better total FLI-C QOL score than radiotherapy. As well, Etoposide resulted in better physical and psychological subscale scores than radiotherapy, 3-drugs and supportive care. Thus, funds permitting, oral Etoposide is a pragmatic approach to treating EKS in an environment where antiretroviral drugs are not universally available. The study underscores the value of undertaking studies in areas of disease prevalence and the necessity of selecting appropriate outcome measures.

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Section: Discussionmentioning

confidence: 99%

Treatment of AIDS-associated Kaposi's sarcoma in Zimbabwe: Results of a randomized quality of life focused clinical trial

Olweny¹,

Borok

Gudza

et al. 2004

Int. J. Cancer

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“…in Central and East Africa) 20 , such as in Uganda 21 . A recent study found HHV-8 infection in early childhood in Uganda unassociated with antibodies to hepatitis A or C virus or with the quality of water supply, which points to a horizontal mode of transmission different to that of developed countries 22 .…”

Section: Epidemiology Of Hhv-8 -Aspects Of Transmissionmentioning

confidence: 99%

Human herpesvirus 8 (HHV-8) and the etiopathogenesis of Kaposi's sarcoma

Leão¹,

Caterino–de–Araujo

Porter

et al. 2002

Rev. Hosp. Clin.

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OBJECTIVE: To review the current literature on human herpesvirus 8 with particular attention to the aspects related to the etiopathogenesis of Kaposi's sarcoma. MATERIALS AND METHODS: The authors searched original research and review articles on specific aspects of human herpesvirus 8 infection, including virology, epidemiology, transmission, diagnosis, natural history, therapy, and Kaposi's sarcoma etiopathogenesis. The relevant material was evaluated and reviewed. RESULTS: Human herpesvirus 8 is a recently discovered DNA virus that is present throughout the world but with major geographic variation. In the Western world, the virus, transmitted mainly by means of sexual contact, is strongly associated with Kaposi's sarcoma and body cavity-based lymphoma and more controversially with multiple myeloma and other non-proliferative disorders. There is no specific effective treatment, but HIV protease inhibitors may play an indirect role in the clearance of human herpesvirus 8 DNA from peripheral blood mononuclear cells of HIV-infected patients. Human herpesvirus 8 DNA is present in saliva, but there are as yet no documented cases of nosocomial transmission to health care workers. The prevalence of human herpesvirus 8 among health care workers is probably similar to that in the general population. CONCLUSION: Human herpesvirus 8 appears to be, at least in Western Europe and United States, restricted to a population at risk of developing Kaposi's sarcoma. Human herpesvirus 8 certainly has the means to overcome cellular control and immune responses and thus predispose carriers to malignancy, particularly Kaposi's sarcoma. The wide diffusion of Human herpesvirus 8 in classic Kaposi's sarcoma areas appears to represent an important factor in the high incidence of the disease. However, additional co-factors are likely to play a role in the development of Kaposi's sarcoma.

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“…Epidemic KS in children commonly involves the lymphatic system and results in a more aggressive clinical course compared with the cutaneous and mucosal presentation commonly seen in adults [18,19,26,28,39,65,66]. Children who acquire HIV via perinatal or breastfeeding transmission are at risk for subsequent HHV-8 infection, and the sequence of viral acquisition may play a role in disease progression.…”

Section: Epidemic Ksmentioning

confidence: 99%