Kaposi Sarcoma in Solid Organ Transplant Recipients: A Single Center Report

Boeckle, Ellen; Boesmueller, C.; Wiesmayr, Silke; Märk, Walter; Rieger, Michael; Tabarelli, Dominique; Graziadei, Ivo; Hoefer, Daniel; Antretter, Herwig; Stelzmueller, Ingrid; Krugmann, Jens; Zangerle, Robert; Huemer, Hartwig P.; Poelzl, Gerhard; Margreiter, R; Bonatti, Hugo

doi:10.1016/j.transproceed.2005.03.144

Cited by 37 publications

(28 citation statements)

References 20 publications

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“…In contrast, a high percentage of our transplant recipients had visceral KS involvement (57%) with a severe disease, refractory to previous specific treatments in six cases. In the literature, the CnI/sirolimus switch was performed either immediately after KS diagnosis concomitantly to withdrawal of other immunosuppressive drugs (10,12,13), or, less frequently, after several months of tapering immunosuppressive therapy at the lowest level (9,11). In the present series, decrease of immunosuppressive therapy preceded from 1 to 124 months (mean 40.5 months) the CnI/sirolimus switch.…”

Section: Discussionmentioning

confidence: 83%

Sirolimus Conversion for Patients with Posttransplant Kaposi's Sarcoma

Lebbe

Euvrard

Barrou

et al. 2006

American Journal of Transplantation

116

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This retrospective study aimed to evaluate the benefit of switching from calcineurin inhibitors (CnI) to sirolimus in posttransplant Kaposi's sarcoma (KS). Fourteen patients monitored in five French departments who had developed posttransplant KS were switched from CnI to sirolimus either abruptly (n = 9) or progressively (n = 5) with trough levels 5-12 ng/mL. Two patients had a complete remission, eight a partial response, and five no significant improvement of KS. The mean time to response was 3.9 months. After a mean follow-up of 16 months, 3 partial responders, with previous severe and refractory KS, suffered again from KS progression despite the lack of concomitant infectious or neoplastic event. These relapses occurred 5-9 months after switching. The tolerance of sirolimus has been excellent except for in one patient who developed severe interstitial pneumonitis. Sirolimus is usually useful in the management of posttransplant KS. It may be, however, ineffective or transiently effective in some patients with severe KS. Prospective studies with pharmacodynamic evaluation are important in order to better assess the duration of responses and the mechanisms of primary and acquired drug resistance.

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Section: Discussionmentioning

confidence: 83%

Sirolimus Conversion for Patients with Posttransplant Kaposi's Sarcoma

Lebbe

Euvrard

Barrou

et al. 2006

American Journal of Transplantation

116

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“…HHV8 positive patients with coinfection from HBV and/ or CMV and/or EBV are exposed to a major risk of developing KS (Boeckle et al 2005). In our experience, every patient was CMV and EBV positive, moreover three patients out of six were HBV positive.…”

Section: Discussionmentioning

confidence: 57%

“…Sirolimus may be administered base on diVerent indications, particularly for complications due to calcineurine inhibitors. More recently a few studies have described the eVectiveness of Sirolimus on the treatment of KS (Guba et al 2002;Stallone et al 2005;Lebbe et al 2006;Gutierrez-Dalmau and Campistol 2005;Boeckle et al 2005). Therefore, since 2003 our policy has been to switch from calcineurin inhibitors to Sirolimus.…”

Section: Discussionmentioning

confidence: 99%

Kaposi’s sarcoma after liver transplantation

Benedetto

Sandro

Ruvo

et al. 2007

J Cancer Res Clin Oncol

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“…Boeckle et al 15 reported fi ve patients with Kaposi's sarcoma among 3815 solid organ transplants performed (0.1%). Immunosuppression was switched in two patients, from tacrolimus to sirolimus.…”

Section: Discussionmentioning

confidence: 99%

Sirolimus for visceral and cutaneous Kaposi's sarcoma in a renal-transplant recipient

et al. 2007

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The incidence of Kaposi's sarcoma among recipients of solid organs is about 500 times the rate in the general population, suggesting a role for immunosuppression in its development. On the basis of these findings, we investigated the impact of sirolimus on cutaneous and disseminated visceral Kaposi's sarcoma in a renal-transplant recipient. The introduction of sirolimus in this patient allowed complete regression of Kaposi's sarcoma (cutaneous and visceral) with preservation of excellent renal function. Meanwhile, in view of the available observational reports, we think that sirolimus should be included in the standard treatment for Kaposi's sarcoma after transplantation, to permit remission of the sarcoma (both cutaneous and visceral) while preserving the renal function.

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Kaposi Sarcoma in Solid Organ Transplant Recipients: A Single Center Report

Cited by 37 publications

References 20 publications

Sirolimus Conversion for Patients with Posttransplant Kaposi's Sarcoma

Sirolimus Conversion for Patients with Posttransplant Kaposi's Sarcoma

Kaposi’s sarcoma after liver transplantation

Sirolimus for visceral and cutaneous Kaposi's sarcoma in a renal-transplant recipient

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