Important note: Information in this article was accurate in 1986. The state of the art may have changed since the publication date.
KAPOSI'S SARCOMA IN AIDS
AIDS. Etiology, Diagnosis, Treatment, and Prevention. DeVita VT, Hellman S, Rosenberg SA, eds. Philadelphia, J. B. Lippincott Company, p. 185-211, 1985.. Unique Identifier : AIDSLINE ICDB/86616578 Krigel RL; Friedman-Kien AE; Fox Chase Cancer Center, Philadelphia, PA
Abstract:
The underlying immunologic deficiency that characterizes acquired immunodeficiency syndrome (AIDS) is an acquired profound disorder of cell-mediated immune functions. This immunologic deficiency predisposes the host to a variety of opportunistic infections and unusual neoplasms, especially the previously uncommon tumor Kaposi's sarcoma (KS). Until the recent epidemic of KS, classic KS remained a rare and unusual tumor. Although most of the cases seen in Europe and North Africa have occurred in elderly men of Italian or Eastern European Jewish ancestry, the neoplasm has also been reported to occur in several other distinct populations as well: young black African adult men and prepubescent children, renal allograft recipients, and other patients (pts) receiving immunosuppressive therapy. The recent epidemic of a disseminated, fulminant form of KS was first observed among young homosexual men in large urban centers in the United States; this new form is referred to as epidemic KS. KS in AIDS is discussed under the following headings: etiology, the diagnosis of KS, histopathologic classification, non-AIDS-related KS (classic KS; African KS; renal transplant-associated KS), epidemic KS (incidence; epidemiology), the histopathology of KS (clinical features; laboratory abnormalities; staging), treatment (local modalities; surgery and irradiation; chemotherapy; biologic response modifiers; current recommendations), and future considerations. There are difficulties in treating epidemic KS. Pts with localized or Stage I disease are treated with local modalities only: surgical excision, electrocautery and curettage, or irradiation therapy. Pts with disseminated disease without B symptoms (systemic signs) are candidates for treatment with potential immunomodulators or single-agent chemotherapy. Pts with disseminated, aggressive, extensive visceral involvement or with B symptoms (systemic signs) are treated with combination chemotherapy. The impact of treatment on survival in epidemic KS has not been demonstrated; currently available treatment is therefore, palliative. (130 Refs)
Keywords: Acquired Immunodeficiency Syndrome/*COMPLICATIONS Adjuvants, Immunologic/THERAPEUTIC USE Adult Africa Aged Antineoplastic Agents/THERAPEUTIC USE Comparative Study Human Male Neoplasm Metastasis Neoplasm Staging Prognosis Sarcoma, Kaposi's/COMPLICATIONS/EPIDEMIOLOGY/*PATHOLOGY/THERAPY Skin Neoplasms/COMPLICATIONS/*PATHOLOGY United States MONOGRAPH REVIEW
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Important note: Information in this article was accurate in 1986. The state of the art may have changed since the publication date.
