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Incidence and outcome of Kaposi sarcoma after hematopoietic stem cell transplantation: a retrospective analysis and a review of the literature, on behalf of infectious diseases working party of EBMT

Bone Marrow Transplantation volume 55, pages 110–116 (2020)Cite this article

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Abstract

The incidence, the clinical characteristics, and the outcome of Kaposi sarcoma (KS) in patients after hematopoietic stem cell transplantation (HSCT) were assessed. During the period 1987–2018, 13 cases of KS were diagnosed, 3 females and 10 males, median age of 50 years, median time from HSCT of 7 months. KS had an incidence of 0.17% in allogeneic and 0.05% in autologous HSCT. HHV-8 was documented in eight of nine tumor tissue samples assessed. The organ involvement was: skin in nine, lymph nodes in six, oral cavity in four, and visceral in three patients, respectively; seven patients had >1 organ involved. Five patients had immunosuppression withdrawn, whereas four and three patients received radiotherapy and chemotherapy, respectively. Eight patients are alive (median follow-up 48 months, range 5–128), whereas five patients died after a median time of 8 months from the diagnosis of KS. However, no death was caused by KS. We conclude that the incidence of KS after HSCT is very low. Although KS can be managed with the reduction of immunosuppression, visceral forms may require chemotherapy and/or radiotherapy. The low prevalence of KS indicates that screening for HHV-8 serology and surveillance for HHV-8 viremia are not indicated in HSCT patients.

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References

  1. Mesri EA, Cesarman E, Boshoff C. Kaposi’s sarcoma and its associated herpesvirus. Nat Rev Cancer. 2010;10:707–19.

    Article  CAS  Google Scholar 

  2. Chang Y, Cesarman E, Pessin MS, Culpepper J, Knowles DM, et al. Identification of herpesvirus-like DNA sequences in AIDS-associated Kaposi’s sarcoma. Science. 1994;266:1865–9.

    Article  CAS  Google Scholar 

  3. Woodle ES, Hanaway M, Buell J, Gross T, First MR, Trofe J, et al. Kaposi sarcoma: an analysis of the US and international experiences from the Israel Penn International TransplantTumor Registry. Transplant Proc. 2001;33:3660–1.

    Article  CAS  Google Scholar 

  4. Deauna-Limayo D, Rajabi B, Qiu W, Htut M, Sweetenham J. Kaposi sarcoma after non myeloablative hematopoietic stem cell transplant: response to withdrawal of immunosuppressant therapy correlated with whole blood human herpesvirus-8 reverse transcriptase-polymerase chain reaction levels. Leuk Lymphoma. 2013;54:2299–302.

    Article  Google Scholar 

  5. Sala I, Faraci M, Magnano GM, Sementa A, di Marco E, Garaventa A, et al. HHV-8-related visceral Kaposi’s sarcoma following allogeneic HSCT: report of a pediatric case and literature reviewHHV-8-related visceral Kaposi!s sarcoma following allogeneic HSCT: report of a pediatric case and literature review. Pediatr Transplant. 2011;15:E8–11.

    Article  Google Scholar 

  6. Heyrman B, De Becker A, Schots R. A case report of immunosuppression-related Kaposi’s sarcoma after autologous stem cell transplantation. BMC Res Notes. 2016;9:188.

    Article  Google Scholar 

  7. Porta F, Bongiorno M, Locatelli F, Gibardi A, Lanfranchi A, Rosso R, et al. Kaposi’s sarcoma in a child after autologous bone marrow transplantation for non-Hodgkin’s lymphoma. Cancer. 1991;68:1361–4.

    Article  CAS  Google Scholar 

  8. Helg C, Adatto M, Salomon D, Roux E, Miralbell R, Chapuis B, et al. Kaposi’s sarcoma following allogeneic bone marrow transplantation. Bone Marrow Transplant. 1994;14:999–1001.

    CAS  PubMed  Google Scholar 

  9. Gluckman E, Parquet N, Scieux C, Deplanche M, Traineau R, Betheau P, et al. KS-associated herpesvirus-like DNA sequences after allogeneic bone-marrow transplantation. Lancet. 1995;346:1558–9.

    Article  CAS  Google Scholar 

  10. Vivancos P, Sarrá J, Palou J, Valls A, Garćia J, Grañena A. Kaposi’s sarcoma after autologous bone marrow transplantation for multiplemyeloma. Bone Marrow Transplant. 1996;17:669–71.

    CAS  PubMed  Google Scholar 

  11. Erer B, Angelucci E, Muretto P, Ripalti M, Rapa S, Gaziev D, et al. Kaposi’s sarcoma after allogeneic bone marrow transplantation. Bone Marrow Transplant. 1997;19:629–31.

    Article  CAS  Google Scholar 

  12. de Medeiros BC, Rezuke WN, Ricci A Jr, Tsongalis G, Shen PU, Bona RD, et al. Kaposi’s sarcoma following allogeneic hematopoietic stem cell transplantation for chronic myelogenous leukemia. Acta Haematol. 2000;104:115–8.

    Article  Google Scholar 

  13. Tamariz-Martel R, Maldonado MS, Carrillo R, Crespo D, Pérez-Caballero C, Muñoz A. Kaposi’s sarcoma after allogeneic bone marrow transplantation in a child. Haematologica. 2000;85:884–5.

    CAS  PubMed  Google Scholar 

  14. Palencia SI, Rodríguez-Peralto JL, Castaño E, de la Serna J, Vanaclocha F, Iglesias-Díez L. Kaposi’s sarcoma after allogeneic peripheral blood stem cell transplantation. Int J Dermatol. 2003;42:647–9.

    Article  Google Scholar 

  15. Bruno B, Sorasio R, Barozzi P, Vieira J, Omedè P, Giaretta F, et al. Kaposi’s sarcoma triggered by endogenous HHV-8 reactivation after non-myeloablative allogeneic haematopoietic transplantation. Eur J Haematol. 2006;76:342–7.

    Article  Google Scholar 

  16. Marco de F, Infante B, Giovanni S, Gesualdo L. Rapamycin for Kaposi’s sarcoma and graft-versus-host disease in bone marrow transplant recipient. Transplantation. 2010;89:633–4.

    Article  Google Scholar 

  17. Ye X, Feng Y, Pang Y, Liu Y, Lin S. Kaposi’s sarcoma developed after allogeneic hematopoietic stem cell transplantation. Oncol Lett. 2011;2:515–8.

    Article  Google Scholar 

  18. Avivi I, Fineman R, Haddad N, Katz T, Oren I, Rowe JM, et al. Fatal Kaposi sarcoma after allogeneic stem cell transplant. Leuk Lymphoma. 2011;52:2402–4.

    Article  Google Scholar 

  19. Abbas AA, Jastaniah WA. Extensive gingival and respiratory tract Kaposi sarcoma in a child after allogenic hematopoietic stem cell transplantation. J Pediatr Hematol Oncol. 2012;34:e53–5.

    Article  Google Scholar 

  20. Guo HX, Huang K, Zhou DH, Wang L, Xiao JH, Weng WJ, et al. Acute leukemia child with ocular Kaposi’s sarcoma after hematopoietic stem cell transplantation: a case report and literature review. Zhonghua Xue Ye Xue Za Zhi. 2013;34:445–8.

    CAS  PubMed  Google Scholar 

  21. Innes AJ, Lee M, Francis N, Olavarria E. Immunosuppression-associated Kaposi sarcoma following stem cell transplantation. Br J Haematol. 2017;178:9.

    Article  Google Scholar 

  22. Ramzi M, Vojdani R, Haghighinejad H. Kaposi Sarcoma After Allogeneic Hematopoietic Stem Cell Transplant: A Rare Complication. Exp Clin Transplant. 2018. https://doi.org/10.6002/ect.2017.0075.

  23. Cesaro S, Berger M Tridello G, Mikulska M, Ward KN, Ljungman P, et al. A survey on incidence and management of adenovirus infection after allogeneic HSCT. Bone Marrow Transplant. 2018. https://doi.org/10.1038/s41409-018-0421-0.

    Article  Google Scholar 

  24. Luppi M, Barozzi P, Schulz TF, Setti G, Staskus K, Trovato R, et al. Bone marrow failure associated with human herpesvirus 8 infection aftertransplantation. N Engl J Med. 2000;343:1378–85.

    Article  CAS  Google Scholar 

  25. Ljungman P, de la Camara R, Cordonnier C, Einsele H, Engelhard D, Reusser P, et al. Management of CMV, HHV-6, HHV-7 and Kaposi-sarcoma herpesvirus (HHV-8) infections in patients with hematological malignancies and after SCT. European Conference on Infections in Leukemia. Bone Marrow Transplant. 2008;42:227–40.

    Article  CAS  Google Scholar 

  26. Gentile G, Capobianchi A, Volpi A, Palù G, Pica F, Calistri A, et al. Human herpesvirus 8 DNA in serum during seroconversion in allogeneic bone marrow transplant recipients. J Natl Cancer Inst. 2005;97:1008–11.

    Article  CAS  Google Scholar 

  27. Rosenzwajg M, Fery N, Bons V, Damaj G, Gluckman E, Gluckman JC. Human herpes virus 8 (HHV8) serology in allogeneic bone marrow transplant recipients. Bone Marrow Transplant. 1999;24:351–4.

    Article  CAS  Google Scholar 

  28. Chiereghin A, Barozzi P, Petrisli E, Piccirilli G, Gabrielli L, Riva G, et al. Multicenter prospective study for laboratory diagnosis of HHV8 infection in solid organ donors and transplant recipients and evaluation of the clinical impact after transplantation. Transplantation. 2017;101:1935–44.

    Article  Google Scholar 

  29. Mazzi R, Parisi SG, Sarmati L, Uccella I, Nicastri E, Carolo G, et al. Efficacy of cidofovir on human herpesvirus 8 viraemia and Kaposi’s sarcoma progression in two patients with. AIDS. 2001;15:2061–2.

    Article  CAS  Google Scholar 

  30. Verucchi G, Calza L, Trevisani F, Zambruni A, Tadolini M, Giuliani R, et al. Human herpesvirus-8-related Kaposi’s sarcoma after liver transplantation successfully treated with cidofovir and liposomal daunorubicin. Transplant Infect Dis. 2005;7:34–7.

    Article  CAS  Google Scholar 

  31. Mocroft A, Youle M, Gazzard B, Morcinek J, Halai R, Phillips AN. Anti-herpesvirus treatment and risk of Kaposi’s sarcoma in HIV infection. AIDS. 1996;10:1101–5.

    Article  CAS  Google Scholar 

Download references

Funding

P.J. (Pilsen Czech Republic) was supported by the grant AZV NV18–03–00277 of the Ministry of Health.

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Authors and Affiliations

  1. Pediatric Hematology Oncology, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy

    Simone Cesaro & Gloria Tridello

  2. EBMT Data Office, Leiden, Netherlands

    Steffie van der Werf

  3. Universitaetsklinikum Frankfurt Goethe-Universitaet, Klinik für Kinder und Jugendmedizin, Frankfurt, Germany

    Peter Bader

  4. Hopital St. Louis, Paris, France

    Gerard Sociè

  5. Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden

    Per Ljungman

  6. Bone MarrowTransplant Unit, Glasgow, UK

    Grant McQuaker

  7. Istituto Giannina Gaslini, Genova, Italy

    Stefano Giardino

  8. Hacettepe University Children’s Hospital, Ankara, Turkey

    Duygu Uckan-Cetinkaya

  9. George Papanicolaou General Hospital, Thessaloniki, Greece

    Achilles Anagnostopoulos

  10. Baskent University Hospital, Adana, Turkey

    Hakan Ozdogu

  11. Universitair Ziekenhuis Brussel, Brussels, Belgium

    Rik Schots

  12. Charles University Hospital, Pilsen, Czech Republic

    Pavel Jindra

  13. Hospital SS.Antonio e Biagio, Alessandria, Italy

    Marco Ladetto

  14. Antwerp University Hospital (UZA), Antwerp, Belgium

    Wilfried Schroyens

  15. Ospedale San Martino, Genova, Italy

    Malgorzata Mikulska

  16. Department of Pediatric Hematology Oncology, University Hospital, Collegium Medicum UMK, Bydgoszcz, Poland

    Jan Styczynski

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  1. Simone Cesaro
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  2. Gloria Tridello
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Correspondence to Simone Cesaro.

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Cesaro, S., Tridello, G., van der Werf, S. et al. Incidence and outcome of Kaposi sarcoma after hematopoietic stem cell transplantation: a retrospective analysis and a review of the literature, on behalf of infectious diseases working party of EBMT. Bone Marrow Transplant 55, 110–116 (2020). https://doi.org/10.1038/s41409-019-0644-8

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