Kaposi Sarcoma after Corticosteroid Therapy for Idiopathic Thrombocytopenic Purpura

Choi, Kwang Hyun; Byun, Jae Ho; Lee, Jun Young; Cho, Baik Kee; Park, Hyun Jeong

doi:10.5021/ad.2009.21.3.297

Cited by 7 publications

(5 citation statements)

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“…Incidence of the KS in South Korea is very low and thus most of the researches were case reports [8,9]. Considering geographic variation of the KS, it would be important to review the treatment in a single-race group.…”

Section: Introductionmentioning

confidence: 99%

Role of radiotherapy in local control of non-AIDS associated Kaposi's sarcoma patients in Korea: a single institution experience

Chang

Kim

2012

Radiat Oncol J

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PurposeThere has been no definite consensus on standard treatment, either local or systemic, for the Kaposi's sarcoma (KS). Radiotherapy (RT) can be a good local therapeutic choice especially in non-AIDS associated KS (NAKS) for its indolent behavior.Materials and MethodsMedical records of 17 KS patients treated with RT at the Seoul National University Hospital from February 1998 to January 2012 were retrospectively reviewed. One human immunodeficiency virus (HIV)+ patient with 3 lesions was excluded. The total number of the lesion was 23 among the 16 patients. The median follow-up period was 27.9 months. Correlation between response and variables was analyzed using the logistic regression model. Median age of the patients was 75 years. All the 23 lesions were located at the extremities. Fourteen (61%) of those had pain or local swelling as the initial presentation. Ten patients had possible causes of immunodeficiency and were regarded as iatrogenic, and other 6 were classic KS. Median dose of RT was 36 Gy.ResultsNo KS-related death was observed. Excluding 2 with short-term follow-up only, complete response and partial response were obtained in 2 (9%) and 19 (73%) lesions, respectively. Of those, 3 lesions underwent local progression. Six had out-of-field recurrence after RT. Symptom improvement was achieved in 13 (93%) of 14 patients. Grade 2 skin toxicities were found in 9 lesions but all got improvement after treatment. When divided into responsive and progressive group, free from progression was not related to any of the possible variables.ConclusionRT is effective in local control of NAKS resulting great response rate.

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Section: Introductionmentioning

confidence: 99%

Role of radiotherapy in local control of non-AIDS associated Kaposi's sarcoma patients in Korea: a single institution experience

Chang

Kim

2012

Radiat Oncol J

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“…[293031] The co-occurrence of iatrogenic KS with idiopathic thrombocytopenic purpura receiving SC treatment was limited to only a few cases reported previously with no risk factor other than corticosteroid-induced immunosuppression, as in one of our iatrogenic KS patients. [32]…”

Section: Discussionmentioning

confidence: 99%

The spectrum of underlying causes of iatrogenic Kaposi's sarcoma in a large series: A retrospective study

et al. 2019

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Background:The frequency of clinicoepidemiological variants of Kaposi's sarcoma (KS) differs markedly throughout the world. The iatrogenic variant is mainly associated with the use of immunosuppressive therapy.Aims:We aimed to investigate the distribution of KS variants in our practice and elucidate the underlying causes of iatrogenic KS.Methods:Consecutive KS patients seen in a single tertiary center were grouped according to the tumor variants and iatrogenic KS patients were evaluated about associated conditions.Results:Among 137 patients, classic variant was the most frequent presentation (n = 88), followed by iatrogenic (n = 37) variant. Among the iatrogenic group, ten were transplant recipients. In 16 iatrogenic KS patients, systemic corticosteroid was used, in four for myasthenia gravis (MG) and in three for rheumatoid arthritis. In three patients, KS developed under topical corticosteroid (TC) treatment. Among iatrogenic KS patients, ten of them had a second primary neoplasm and one had congenital immunodeficiency syndrome.Conclusions:Our study revealed one of the highest rates for iatrogenic KS (27%) reported in the literature. Besides well-known causes, relatively frequent association with MG was remarkable. Usage of different forms of TCs was the cause of KS in a few cases.

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“…Noor Akmal and Abdul Wahab [ 16 ] reported findings on a patient who developed Kaposi’s sarcoma during corticosteroid therapy for ITP. Choi et al reported that Kaposi’s sarcoma occurred during immunosuppressive medication, including corticosteroid therapy for ITP, which has an unpredictably poor prognosis [ 66 ].…”

Section: Immune Thrombocytopenia and Malignancymentioning

confidence: 99%

A Review on Secondary Immune Thrombocytopenia in Malaysia

et al. 2021

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Immune thrombocytopenia (ITP) is an acquired autoimmune disease that occurs in adults and children. In Malaysia, the clinical practice guideline (CPG) for the management of ITP was issued in 2006, which focused almost exclusively on primary ITP (pITP), and only a few secondary ITP (sITP) forms were addressed. All published (twenty-three) sITP articles among children and adults in Malaysia, identified on the academic databases were retrieved. The articles were published between 1981 and 2019, at a rate of 0.62 publications per year. The publications were considered low and mainly focused on rare presentation and followed-up of secondary diseases. This review revealed that sITP in Malaysia is commonly associated with autoimmune diseases (Evan’s syndrome, SLE and WAS), malignancy (Kaposi’s sarcoma and breast cancer) and infection (dengue haemorrhagic fever, Helicobacter pylori and hepatitis C virus). The relationship between ITP and autoimmune diseases, malignancy and infections raise the question concerning the mechanism involved in these associations. Further studies should be conducted to bridge the current knowledge gap, and the further information is required to update the existing CPG of management of ITP in Malaysia.

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Kaposi Sarcoma after Corticosteroid Therapy for Idiopathic Thrombocytopenic Purpura

Abstract: Fig. 1. (A)Multiple, dark-red colored nodules on the extremities that were several centimeters in size. (B) After the cessation of corticosteroids for 6 months, the skin nodules decreased in sized and number.

Cited by 7 publications

References 9 publications

Role of radiotherapy in local control of non-AIDS associated Kaposi's sarcoma patients in Korea: a single institution experience

Role of radiotherapy in local control of non-AIDS associated Kaposi's sarcoma patients in Korea: a single institution experience

The spectrum of underlying causes of iatrogenic Kaposi's sarcoma in a large series: A retrospective study

A Review on Secondary Immune Thrombocytopenia in Malaysia

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