title: Successful treatment of post-transplant Kaposi's sarcoma by reduction of immunosuppression.
abstract: BACKGROUND
  The aim of this study was to investigate retrospectively the clinical presentation, the efficacy of reducing immunosuppression and the consequences of this therapeutic approach in Kaposi's sarcoma (KS) developing after renal transplantation.
  
  
  METHODS
  We reviewed the records of 502 patients who had been followed up at our transplantation unit between October 1, 1987 and December 30, 1998. Twelve patients (2.4%) with KS were included in the study.
  
  
  RESULTS
  The mean age of KS patients was 38+/-11 years (one female, 11 males). All were on prednisone, azathioprine (AZT) and cylcosporin treatment. KS was encountered at a mean of 18+/-10 months post-renal transplantation. Typical Kaposi's lesions were present in the skin of 11 out of l2 patients. In the only patient without skin involvement, who died from haemophagocytic histiocytic syndrome caused by septicaemia, KS was diagnosed post-mortem in a lymph node. In five patients only skin involvement was present, while the others also had visceral involvement (oropharynx in two patients, trachea and lung in three, lymph node in two, stomach and duodenum in two). Cyclosporin was stopped within 1 month after KS diagnosis, and AZT was stopped in three patients. Both cutaneous and visceral KS manifestations disappeared and no patient was lost due to KS. During a follow-up period 46+/-19 months, KS recurred in the lungs in one patient together with lung tuberculosis, while he was on prednisone and AZT. Two patients lost their graft due to chronic rejection. The remaining eight patients currently have a functioning graft with a mean creatinine level of 1.4+/-0.5 mg/dl.
  
  
  CONCLUSIONS
  KS is the most frequent post-transplant neoplasia (80%) in our country. In the present study cohort, half of the patients had visceral involvement. Reduction or discontinuation of immunosuppression caused complete remission in all patients without surgical intervention, chemotherapy or radiotherapy.
authors: Department of Nephrology and. Department of Dermatology, Ege University Medical School, Izmir, Turkey. dumans@med.ege.edu.tr
authors: Soner
authors: S
authors: Duman
authors: Hüseyin
authors: H
authors: Töz
authors: Gülay
authors: G
authors: Aşçi
authors: Sibel
authors: S
authors: Alper
authors: Mehmet
authors: M
authors: Ozkahya
authors: Idil
authors: I
authors: Unal
authors: Ali
authors: A
authors: Celik
authors: Ercan
authors: E
authors: Ok
authors: Ali
authors: A
authors: Başçi
mesh_terms: D000328:Adult; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012514:Sarcoma, Kaposi / Q000209:etiology* / Q000628:therapy*; D012878:Skin Neoplasms / Q000209:etiology* / Q000628:therapy*
chemical_list: D007166:Immunosuppressive Agents