Posttransplant Kaposi sarcoma: Analysis of a series of 13 patients

Abstract

Introduction and objectives: This study reflects our experience in the management of posttransplant Kaposi Sarcoma (KS) and assesses the clinical relevance of monitoring HHV-8 DNA viral load in peripheral blood by qPCR.

Patients and methods: Retrospective study of all patients diagnosed with posttransplant KS during the period 1995-2019. In 8 patients, we performed a qPCR in serum for HHV-8 DNA detection at diagnosis and/or during follow-up.

Results: Data from 13 organ transplant recipients with a diagnosis of iatrogenic KS were collected. Reduction and/or discontinuation of one or more immunosuppressive agent(s) along with switching to an mTOR inhibitor was part of the treatment approach in 12 (92%) patients. Overall response rate (including complete response, partial response, and stable disease) was observed in 9 patients. At diagnosis, HHV-8 qPCR in serum was positive in 2 out of 5 patients. During follow-up, both positive cases turned negative, as a clinical response.

Conclusions: Our work highlights the critical role of reduction of immunosuppression and conversion to an mTOR inhibitor in the management of posttransplant KS.

Keywords: Herpes virus humano 8; Human Herpesvirus 8; Immunosuppression; Inhibidor de mTOR; Inmunosupresión; Kaposi sarcoma; Neoplasias postrasplante; Post-transplant malignancies; Receptores de un trasplante de órgano sólido; Sarcoma de Kaposi; Solid-organ transplant recipient; mTOR inhibitor.