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Management of Kaposi sarcoma after solid organ transplantation: A European retrospective study

par Delyon, Julie;Rabate, Clementine;Euvrard, Sylvie;Harwood, Catherine Anne;Proby, Charlotte;Güleç, Ayşe Tülin;Seckin, Deniz;Del Marmol, Véronique ;Bouwes Bavinck, Jan Nico;Ferrándiz-Pulido, Carla;Ocampo, Maria Andrea;Barete, Stéphane;Legendre, Christophe;Francès, Camille;Porcher, Raphaël;Lebbe, Céleste
Référence Journal of the American Academy of Dermatology
Publication Publié, 2019-12-01

Article révisé par les pairs

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Résumé :

Background: Systemic therapeutic management of post-transplant Kaposi sarcoma (KS) is mainly based on 3 axes: reduction of immunosuppression, conversion to mammalian target of rapamycin (mTOR) inhibitors, chemotherapy, or a combination of these. Objective: To obtain an overview of clinical strategies about the current treatment of KS. Methods: We conducted a multicenter retrospective cohort study including 145 solid organ transplant recipients diagnosed with KS between 1985 and 2011 to collect data regarding first-line treatment and response at 6 months. Results: Overall, 95%, 28%, and 16% of patients had reduction of immunosuppression, conversion to mTOR inhibitor, and chemotherapy, respectively. Patients treated with chemotherapy or mTOR inhibitor conversion were more likely to have visceral KS. At 6 months, 83% of patients had response, including 40% complete responses. Limitations: The retrospective design of the study. Conclusion: Currently available therapeutic options seem to be effective to control KS in most patients. Tapering down the immunosuppressive regimen remains the cornerstone of KS management.