title: Association of clinical progression in classic Kaposi's sarcoma with reduction of peripheral B lymphocytes and partial increase in serum immune activation markers.
abstract: OBJECTIVE
  To evaluate various immunologic markers in the peripheral blood of patients with early and advanced classic Kaposi's sarcoma (CKS).
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  A major referral center for skin and venereal diseases.
  
  
  METHODS
  Sixty-eight patients with histologically confirmed CKS staged according to a modified version of the Mitsuyasu-Groopman classification in stage I-II (cutaneous involvement only) and stage IV (skin and systemic involvement).
  
  
  METHODS
  Concentrations of neopterin and beta2-microglobulin, titer of anti-human herpesvirus 8 antibodies, number of natural killer cells, and numbers of total lymphocytes, B lymphocytes, T lymphocytes, and their subsets in peripheral blood.
  
  
  RESULTS
  The median values of beta2-microglobulin and neopterin were elevated in patients with CKS in stage IV (median, 3.679 microg/mL [312.72 nmol/L] and 14.0 nmol/L, respectively) compared with patients in stage I-II (median, 2.406 microg/mL [204.51 nmol/L] and 6.5 nmol/L, respectively). A statistically significant reduction in total lymphocyte and B-lymphocyte counts was observed in patients with advanced-stage CKS (1679/microL and 79/microL, respectively) compared with patients in earlier stages of the disease (2142/microL and 224/microL, respectively). The human herpesvirus 8 antibody titer, determined by latent immunofluorescent assay, decreased from stage I-II to stage IV, although not at a statistically significant level (P = .14).
  
  
  CONCLUSIONS
  The evolution of CKS from the early stages of the disease to the more advanced may be associated with a partial activation of the immune system and a gradual decrease in the number of total and B lymphocytes.
authors.affiliation: Department of Dermatology, University of Athens, Andreas Sygros Hospital, Athens, Greece. alstrat@hol.gr
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Stratigos
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Malanos
authors.forename: Giota
authors.initials: G
authors.lastname: Touloumi
authors.forename: Anna
authors.initials: A
authors.lastname: Antoniou
authors.forename: Irene
authors.initials: I
authors.lastname: Potouridou
authors.forename: Dorothea
authors.initials: D
authors.lastname: Polydorou
authors.forename: Andreas D
authors.initials: AD
authors.lastname: Katsambas
authors.forename: Denise
authors.initials: D
authors.lastname: Whitby
authors.forename: Nancy
authors.initials: N
authors.lastname: Mueller
authors.forename: John D
authors.initials: JD
authors.lastname: Stratigos
authors.forename: Angelos
authors.initials: A
authors.lastname: Hatzakis
mesh_terms: D000368:Aged; D000914:Antibodies, Viral / Q000097:blood; D001402:B-Lymphocytes / Q000166:cytology; D014408:Biomarkers, Tumor / Q000097:blood*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D019288:Herpesvirus 8, Human / Q000276:immunology; D006801:Humans; D008213:Lymphocyte Activation; D008297:Male; D009367:Neoplasm Staging; D019798:Neopterin / Q000097:blood; D012514:Sarcoma, Kaposi / Q000378:metabolism* / Q000473:pathology; D013601:T-Lymphocytes / Q000166:cytology; D001613:beta 2-Microglobulin / Q000097:blood
chemical_list: D000914:Antibodies, Viral; D014408:Biomarkers, Tumor; D001613:beta 2-Microglobulin; D019798:Neopterin