Human herpes virus type 8-associated Kaposi sarcoma in a pediatric liver transplant recipient.
Development of KS in pediatric liver transplant recipients is a rare entity and has dismal prognosis. Latent HHV-8 infection, immunosuppression, and genetic predisposition are possible etiological factors. Decreasing the dose or cessation of immunosuppressive drugs, switching to sirolimus with antiproliferative and antitumor properties, and different chemotherapeutic regimens are the current therapeutic strategies. We herein report a pediatric liver transplant recipient who developed generalized KS at post-transplant fifth month. The disease had an aggressive course despite the highly toxic chemotherapy. On the other hand, a prompt and durable response was provided by paclitaxel with tolerable side effects. The patient is now free of disease for at least 24 months and healthy with good graft function under sirolimus therapy as maintenance immunosuppression. Instead of highly toxic chemotherapy, paclitaxel can be used as therapeutic option in cases with generalized disease and in those who are unresponsive to conventional chemotherapy. However, new studies are needed to assess the efficacy of the paclitaxel therapy in KS in the liver transplant recipients.
Celtik
Coşkun
C
Department of Pediatric Gastroenterology, Hepatology and Nutrition Department of Pediatric Hematology, Istanbul, Turkey.
Unüvar
Ayşegül
A
Aydoğan
Ayşen
A
Gökçe
Selim
S
Oztürk
Gülyüz
G
Güllüoğlu
Mine
M
Yılmaz
Gülden
G
Türkoğlu
Salih
S
Anak
Sema
S
Sökücü
Semra
S
Durmaz
Ozlem
O
D000970:Antineoplastic Agents / Q000627:therapeutic use; D005260:Female; D019288:Herpesvirus 8, Human / Q000235:genetics*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D007223:Infant; D017093:Liver Failure / Q000150:complications* / Q000821:virology*; D016031:Liver Transplantation / Q000009:adverse effects*; D008232:Lymphoproliferative Disorders / Q000821:virology; D017239:Paclitaxel / Q000627:therapeutic use; D011379:Prognosis; D012514:Sarcoma, Kaposi / Q000150:complications* / Q000821:virology*; D020123:Sirolimus / Q000627:therapeutic use; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents; D017239:Paclitaxel; D020123:Sirolimus