Risk of Kaposi sarcoma after solid organ transplantation in the United States

Cahoon, Elizabeth K.; Linet, Martha S.; Clarke, Christina A.; Pawlish, Karen; Engels, Eric A.; Pfeiffer, Ruth M.

doi:10.1002/ijc.31735

Cited by 59 publications

(65 citation statements)

References 36 publications

(44 reference statements)

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“…There are few reported cases of pediatric PTKS, possibly because pediatric patients are less likely than adults to have been previously infected with HHV‐8 at the time of transplant. Indeed, risk of PTKS is associated with older age at the time of transplant . Our search of the literature revealed 8 studies of a total of 25 pediatric cases of PTKS .…”

Section: Discussionsupporting

confidence: 60%

“…Indeed, risk of PTKS is associated with older age at the time of transplant. 2 Our search of the literature revealed 8 studies of a total of 25 pediatric cases of PTKS. 5,[10][11][12][13][14][15][16] As was seen in our patient, many prior patients who have been described presented earlier after transplant than the adult median, and pediatric patients more commonly had visceral involvement than purely cutaneous disease.…”

Section: Ptks Like Non-transplant-associated Ksmentioning

confidence: 99%

“…However, in the United States, where seroprevalence is low (estimated 0%‐5%), it is much less frequently described. A recent study found that in the United States, 0.06% of SOT recipients develop PTKS, most within one year of transplant . There is little comprehensive literature on pediatric PTKS.…”

Section: Introductionmentioning

confidence: 99%

“…A recent study found that in the United States, 0.06% of SOT recipients develop PTKS, most within one year of transplant. 2 There is little comprehensive literature on pediatric PTKS. Here, we describe a case of PTKS in a North American 15-month-old liver transplant recipient.…”

Section: Introductionmentioning

confidence: 99%

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Pediatric post‐transplant hepatic kaposi sarcoma due to donor‐derived human herpesvirus 8

Ocwieja

Vargas

Elisofon

et al. 2019

Pediatric Transplantation

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In areas of the world where human herpesvirus 8 (HHV‐8) is endemic, Kaposi sarcoma (KS) is a common SOT‐associated cancer. In the United States, where the virus is not prevalent, PTKS is rare, and there is little literature on pediatric PTKS. We present a North American female who underwent deceased donor, left lateral segment liver transplant for biliary atresia at age 11 months. The donor was a male with no known history of KS, originally from an HHV‐8‐endemic country. Three months after transplantation, the patient developed liver nodules and portal vein thrombosis. Analysis of needle biopsy established the diagnosis of KS and confirmed that the transformed cells were donor‐derived. HHV‐8 viremia was detected, and ganciclovir dosing (which had been started prophylactically) was increased. Immunosuppression was changed from tacrolimus to sirolimus. After further disease progression, 8 cycles of paclitaxel were administered. Under this treatment, her nodules regressed, HHV‐8 viremia resolved, and she had marked clinic improvement. Notably, the adult recipient of the right liver lobe from the same donor also developed PTKS. This is one of few pediatric PTKS cases described in the literature. It contributes to the mechanistic understanding of PTKS development, illustrating the risk posed by donors from HHV‐8‐endemic countries, as well as the potential for strong PTKS correlation between multiple recipients of organs from a single shared donor.

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Section: Discussionsupporting

confidence: 60%

Section: Ptks Like Non-transplant-associated Ksmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pediatric post‐transplant hepatic kaposi sarcoma due to donor‐derived human herpesvirus 8

Ocwieja

Vargas

Elisofon

et al. 2019

Pediatric Transplantation

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“…Onset is rapid after transplantation among SOTRs, 81 Onset is rapid after transplantation among SOTRs, 81 …”

Section: Scenario 1: Very Strong Immune Selection Against Viral Neomentioning

confidence: 99%

Epidemiologic perspectives on immunosuppressed populations and the immunosurveillance and immunocontainment of cancer

Engels

2019

American Journal of Transplantation

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The advent in the last several years of effective immunotherapy for cancer has renewed interest in the role of the immune system in controlling cancer. The idea that the immune system can help control cancer has a long history. Solid organ transplant recipients (SOTRs) as well as human immunodeficiency virus (HIV)-infected people are affected by cell-mediated immune dysfunction. Epidemiologic studies of these populations reveal a pattern characterized by a strongly increased incidence of virus-related cancers (eg, Kaposi sarcoma, non-Hodgkin lymphoma, and anogenital cancers). In addition, recent epidemiologic studies have evaluated cancer-specific mortality among SOTRs and HIV-infected people following a cancer diagnosis. For a wider range of cancers-not limited to those caused by viruses, and including melanoma and cancers of the colorectum, lung, and breast-these immunosuppressed cancer patients have higher cancer-specific mortality than other cancer patients. This latter group of cancers somewhat mirrors those for which immunotherapy with checkpoint inhibitors is approved. These epidemiologic observations suggest that there are 2 distinct immune selection processes in humans: immunosurveillance directed against premalignant cells before cancer diagnosis (most relevant for preventing virus-related cancers), and "immunocontainment" directed against established cancers. These processes thus appear relevant for different groups of malignancies and may have different mechanisms. K E Y W O R D Scancer/malignancy/neoplasia, cancer/malignancy/neoplasia: registry/incidence, cancer/ malignancy/neoplasia: risk factors, clinical research/practice, epidemiology, hematology/ oncology, immune deficiency, immunosuppression/immune modulation, translational research/science | INTRODUC TI ONThe advent in the last several years of effective immunotherapy for cancer has renewed interest in the role of the immune system in controlling cancer. 1-3 The field of cancer immunotherapy has long drawn support from the observation that immunosuppressed individuals, including solid organ transplant recipients (SOTRs), have an elevated risk of developing cancer. 2 In this Personal

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Violaceous Nodules on the Right Leg and Foot

Chen,

Chuang,

2023

JAMA

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A patient with a history of bullous pemphigoid treated with oral prednisolone presented with multiple round, dark brown to violaceous-colored firm nodules on the right leg and 2 nodular masses with hemorrhagic crusts on the right foot. Complete blood cell count and creatinine and liver function test results were normal, and results of HIV antibody testing were negative. What is the diagnosis and what would you do next?

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Risk of Kaposi sarcoma after solid organ transplantation in the United States

Cited by 59 publications

References 36 publications

Pediatric post‐transplant hepatic kaposi sarcoma due to donor‐derived human herpesvirus 8

Pediatric post‐transplant hepatic kaposi sarcoma due to donor‐derived human herpesvirus 8

Epidemiologic perspectives on immunosuppressed populations and the immunosurveillance and immunocontainment of cancer

Violaceous Nodules on the Right Leg and Foot

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