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

Julie Delyon; Clementine Rabate; Sylvie Euvrard; Catherine A. Harwood; Charlotte Proby; A. Tülin Güleç; Deniz Seçkin; Veronique Del Marmol; Jan Nico Bouwes-Bavinck; Carla Ferrándiz-Pulido; Maria Andrea Ocampo; Stephane Barete; Christophe Legendre; Camille Francès; Raphael Porcher; Celeste Lebbe

doi:10.1016/j.jaad.2019.03.028

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

, Julie Delyon
, Clementine Rabate
, Sylvie Euvrard
, Catherine A. Harwood
, Charlotte Proby
, A. Tülin Güleç
, Deniz Seçkin
, Veronique Del Marmol
, Jan Nico Bouwes-Bavinck
, Carla Ferrándiz-Pulido
, Maria Andrea Ocampo
, Stephane Barete
, Christophe Legendre
, Camille Francès
, Raphael Porcher
, Celeste Lebbe

Research output: Contribution to journal › Article › peer-review

44 Citations (Scopus)

219 Downloads (Pure)

Abstract

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.

Original language	English
Pages (from-to)	448-455
Number of pages	8
Journal	Journal of the American Academy of Dermatology
Volume	81
Issue number	2
Early online date	19 Mar 2019
DOIs	https://doi.org/10.1016/j.jaad.2019.03.028
Publication status	Published - Aug 2019

Keywords

chemotherapy
immunosuppression
Kaposi sarcoma
mTOR inhibitor
organ transplantation
post-transplant malignancies

ASJC Scopus subject areas

Dermatology

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10.1016/j.jaad.2019.03.028

Author Accepted ManuscriptAccepted author manuscript, 912 KBLicence: CC BY-NC-ND

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, Delyon, J., Rabate, C., Euvrard, S., Harwood, C. A., Proby, C., Güleç, A. T., Seçkin, D., Del Marmol, V., Bouwes-Bavinck, J. N., Ferrándiz-Pulido, C., Ocampo, M. A., Barete, S., Legendre, C., Francès, C., & Porcher, R., & Lebbe, C. (2019). Management of Kaposi sarcoma after solid organ transplantation: A European retrospective study. Journal of the American Academy of Dermatology, 81(2), 448-455. https://doi.org/10.1016/j.jaad.2019.03.028

@article{2bd0122703be44f98ff358b1fb59a006,

title = "Management of Kaposi sarcoma after solid organ transplantation: A European retrospective study",

abstract = "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.",

keywords = "chemotherapy, immunosuppression, Kaposi sarcoma, mTOR inhibitor, organ transplantation, post-transplant malignancies",

author = "Julie Delyon and Clementine Rabate and Sylvie Euvrard and Harwood, \{Catherine A.\} and Charlotte Proby and G{\"u}le{\c c}, \{A. T{\"u}lin\} and Deniz Se{\c c}kin and \{Del Marmol\}, Veronique and Bouwes-Bavinck, \{Jan Nico\} and Carla Ferr{\'a}ndiz-Pulido and Ocampo, \{Maria Andrea\} and Stephane Barete and Christophe Legendre and Camille Franc{\`e}s and Raphael Porcher and Celeste Lebbe",

year = "2019",

month = aug,

doi = "10.1016/j.jaad.2019.03.028",

language = "English",

volume = "81",

pages = "448--455",

journal = "Journal of the American Academy of Dermatology",

issn = "0190-9622",

publisher = "Elsevier",

number = "2",

}

Delyon, J, Rabate, C, Euvrard, S, Harwood, CA, Proby, C, Güleç, AT, Seçkin, D, Del Marmol, V, Bouwes-Bavinck, JN, Ferrándiz-Pulido, C, Ocampo, MA, Barete, S, Legendre, C, Francès, C & Porcher, R & Lebbe, C 2019, 'Management of Kaposi sarcoma after solid organ transplantation: A European retrospective study', Journal of the American Academy of Dermatology, vol. 81, no. 2, pp. 448-455. https://doi.org/10.1016/j.jaad.2019.03.028

TY - JOUR

T1 - Management of Kaposi sarcoma after solid organ transplantation

T2 - A European retrospective study

AU - Delyon, Julie

AU - Rabate, Clementine

AU - Euvrard, Sylvie

AU - Harwood, Catherine A.

AU - Proby, Charlotte

AU - Güleç, A. Tülin

AU - Seçkin, Deniz

AU - Del Marmol, Veronique

AU - Bouwes-Bavinck, Jan Nico

AU - Ferrándiz-Pulido, Carla

AU - Ocampo, Maria Andrea

AU - Barete, Stephane

AU - Legendre, Christophe

AU - Francès, Camille

AU - Porcher, Raphael

AU - Lebbe, Celeste

PY - 2019/8

Y1 - 2019/8

N2 - 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.

AB - 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.

KW - chemotherapy

KW - immunosuppression

KW - Kaposi sarcoma

KW - mTOR inhibitor

KW - organ transplantation

KW - post-transplant malignancies

UR - https://www.scopus.com/pages/publications/85067440035

U2 - 10.1016/j.jaad.2019.03.028

DO - 10.1016/j.jaad.2019.03.028

M3 - Article

C2 - 30902727

AN - SCOPUS:85067440035

SN - 0190-9622

VL - 81

SP - 448

EP - 455

JO - Journal of the American Academy of Dermatology

JF - Journal of the American Academy of Dermatology

IS - 2

ER -

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

Abstract

Keywords

ASJC Scopus subject areas

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