Important note: Information in this article was accurate in 1995. The state of the art may have changed since the publication date.
Kaposi's sarcoma: a reevaluation (Meeting abstract).
Melanoma Res; 3:6 1993. Unique Identifier : AIDSLINE ICDB/95607230 Orfanos CE; Dept. of Dermatology, University Medical Center Steglitz, The; Free University of Berlin, Berlin, Germany
Abstract:
Kaposi's sarcoma is a multicentric neoplasia of microvascular origin arising during developing immunodeficiency in HIV-infected individuals. Over 130 patients with HIV-associated Kaposi's sarcoma (98% male homosexuals, median age: 35 years) have been seen in our Berlin Department during 1982-1992. In some cases the tumor remained stable on the skin for greater than 6 months, but in the majority of the cases it disseminated rapidly, partly with lethal outcome. Mucocutaneous visceral involvement was found in 3% of the cases during the first visit and in 36% after control examination 2 years later. Up to 30-40% pulmonary involvement, 40% gastrointestinal involvement, etc was seen during the prefinal stages of the disease. As a rule, the tumor appears approx 2 years after HIV-infection at the average, 90% of the patients were found to be immune suppressed by the time of the first visit. However, immunosuppression was not a prerequisite for the appearance of the neoplasm. HSV, CMV, HPV, certain growth-inducing cytokines (TNF-alpha, IFN-gamma, IL-4, IL-6) are seemingly co-factors, among others. As prognostic predictors (a) the stage of dissemination by the first visit, (b) mucosal manifestation and (c) the degree of immune suppression were found valid. Mean survival time was 28 months in patients with greater than 300 CD4+ lymphocytes (n = 18) and 14 months in immune suppressed (less than 300 CD4+ cells) individuals with KS (n = 70). The median survival time after first diagnosis in the entire group evaluated (n = 89 patients) was 17 months. In 71 HIV-infected individuals who died at the University Medical Center Steglitz during the last 8 yr, disseminated KS was cause of death in 28% of the cases, indicating the malignant potential of the neoplasm. Local therapies include excision, cryotherapy, lasers, x-rays, local cytostatics (pe vincristine 0.1-0.5 mg per lesion) and local application of rIFN-alpha. Systemically combined immunochemotherapies are given, mostly vinca alkaloids together with rIFN-alpha (3-18 million IU every 2 days) over several months. Prolongation of survival is to be expected after such treatment modalities (together with antiretroviral medications) in 30-40% of the cases. Bleomycin, etoposide, epirubicin and other cytostatics have also been applied with moderate results.
Keywords: Adult Combined Modality Therapy Female Gastrointestinal Neoplasms Human HIV Infections/COMPLICATIONS/IMMUNOLOGY Lung Neoplasms Male *Sarcoma, Kaposi's Skin Neoplasms Survival Analysis ABSTRACT 950630
M9561168
AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.
Important note: Information in this article was accurate in 1995. The state of the art may have changed since the publication date.
