Kaposi's sarcoma classification: Difference between revisions

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*[[Radiotherapy]] is a treatment option for the multifocal but relatively localized [[KS]]. <br />
*[[Radiotherapy]] is a treatment option for the multifocal but relatively localized [[KS]]. <br />
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" rowspan="6;" | Endemic
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" rowspan="6;" | Endemic <ref name="pmid213772672">{{cite journal| author=Uldrick TS, Whitby D| title=Update on KSHV epidemiology, Kaposi Sarcoma pathogenesis, and treatment of Kaposi Sarcoma. | journal=Cancer Lett | year= 2011 | volume= 305 | issue= 2 | pages= 150-62 | pmid=21377267 | doi=10.1016/j.canlet.2011.02.006 | pmc=3085592 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21377267  }}</ref>
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" rowspan="1;"|Common features
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" rowspan="1;"|Common features
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*
* Usually seen in areas with high [[prevalence]] of [[HHV-8]] such as sub-Saharan Africa
* If caused by an undiagnosed [[HIV]] infection, it can be treated by [[antiretroviral]] medications
* Kaposi’s sarcoma-associated herpesvirus ([[KSHV]])
*[[KSHV]] [[infection]] is very common in sub-Saharan Africa with seropositivity rates of >50%
*If caused by [[infection]] other than [[HIV]], it can be treated by radiotherapy or [[chemotherapy]]
*The burden of [[HIV]] and [[KSHV]] [[coinfection]] is high in sub-Saharan Africa
*The access to combined [[cART]] is expanding but still limited
*[[KS]] surveillance programs are insufficient
*[[combination therapy]] of [[cART]] and [[chemotherapy]] has 66% response rate
*The limitations of achieving an optimal and affordable [[therapeutic]] approach is:
*Resource-limited settings and infrastructure issues such as lack of trained personnel to administer [[chemotherapy]] and lack of [[infusion]] centers, and the inability to monitor blood work,  a high rate of co-morbid [[tuberculosis]]
*Oral agents such as [[etoposide]] may have the benefit of easing the administration
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" rowspan="1;"|African [[cutaneous]]  Kaposi's sarcoma
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" rowspan="1;"|African [[cutaneous]]  Kaposi's sarcoma
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*
*[[Risk factors]] (other than HIV)
** Chronic [[malaria]]
** Chronic [[parasitic infections]]
**[[Malnutrition]]
|-
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" rowspan="1;"|African [[Lymphadenopathy|lymphadenopathic]]  Kaposi's sarcoma
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" rowspan="1;"|African [[Lymphadenopathy|lymphadenopathic]]  Kaposi's sarcoma
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*
** A very aggressive form
* Affects very young children, < 10 years of age
* Not related to [[HIV]]
*Affects the [[skin]] and [[lymph nodes]]
*[[Risk factors]] (other than HIV)
** Chronic [[malaria]]
** Chronic [[parasitic infections]]
**[[Malnutrition]]
|-
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |[[Iatrogenic]] ([[transplant]]-related) Kaposi's sarcoma (immunosuppression-associated Kaposi's sarcoma)<ref name="pmid4884743">{{cite journal| author=Siegel JH, Janis R, Alper JC, Schutte H, Robbins L, Blaufox MD| title=Disseminated visceral Kaposi's sarcoma. Appearance after human renal homograft operation. | journal=JAMA | year= 1969 | volume= 207 | issue= 8 | pages= 1493-6 | pmid=4884743 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4884743  }}</ref><ref name="pmid728865">{{cite journal| author=Klepp O, Dahl O, Stenwig JT| title=Association of Kaposi's sarcoma and prior immunosuppressive therapy: a 5-year material of Kaposi's sarcoma in Norway. | journal=Cancer | year= 1978 | volume= 42 | issue= 6 | pages= 2626-30 | pmid=728865 | doi=10.1002/1097-0142(197812)42:6<2626::aid-cncr2820420618>3.0.co;2-7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=728865  }}</ref>
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |[[Iatrogenic]] ([[transplant]]-related) Kaposi's sarcoma (immunosuppression-associated Kaposi's sarcoma)<ref name="pmid4884743">{{cite journal| author=Siegel JH, Janis R, Alper JC, Schutte H, Robbins L, Blaufox MD| title=Disseminated visceral Kaposi's sarcoma. Appearance after human renal homograft operation. | journal=JAMA | year= 1969 | volume= 207 | issue= 8 | pages= 1493-6 | pmid=4884743 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4884743  }}</ref><ref name="pmid728865">{{cite journal| author=Klepp O, Dahl O, Stenwig JT| title=Association of Kaposi's sarcoma and prior immunosuppressive therapy: a 5-year material of Kaposi's sarcoma in Norway. | journal=Cancer | year= 1978 | volume= 42 | issue= 6 | pages= 2626-30 | pmid=728865 | doi=10.1002/1097-0142(197812)42:6<2626::aid-cncr2820420618>3.0.co;2-7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=728865  }}</ref>

Revision as of 09:41, 17 October 2019


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2] Huda A. Karman, M.D.

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Overview

Kaposi's sarcoma may be classified according to the clinical setting of the disease into five subtypes include Classic Kaposi's sarcoma, African cutaneous Kaposi's sarcoma, African lymphadenopathic Kaposi's sarcoma, Immunosuppression-associated Kaposi's sarcoma, and AIDS-associated Kaposi's sarcoma.

Classification

  • According to the clinical setting of the disease, clinical presentation, epidemiology, and prognosis Kaposi's sarcoma may be classified into five different subtypes which include:[1][2][3]
  • Classic Kaposi's sarcoma
  • African cutaneous Kaposi's sarcoma
  • African lymphadenopathic Kaposi's sarcoma
  • Iatrogenic Kaposi's sarcoma (immunosuppression-associated Kaposi's sarcoma)
  • AIDS-associated Kaposi's sarcoma



Types Characteristics
Classic (Mediterranean) Kaposi's sarcoma [4][5][6][7]
Endemic [8] Common features
  • Usually seen in areas with high prevalence of HHV-8 such as sub-Saharan Africa
  • If caused by an undiagnosed HIV infection, it can be treated by antiretroviral medications
  • Kaposi’s sarcoma-associated herpesvirus (KSHV)
  • KSHV infection is very common in sub-Saharan Africa with seropositivity rates of >50%
  • If caused by infection other than HIV, it can be treated by radiotherapy or chemotherapy
  • The burden of HIV and KSHV coinfection is high in sub-Saharan Africa
  • The access to combined cART is expanding but still limited
  • KS surveillance programs are insufficient
  • combination therapy of cART and chemotherapy has 66% response rate
  • The limitations of achieving an optimal and affordable therapeutic approach is:
  • Resource-limited settings and infrastructure issues such as lack of trained personnel to administer chemotherapy and lack of infusion centers, and the inability to monitor blood work, a high rate of co-morbid tuberculosis
  • Oral agents such as etoposide may have the benefit of easing the administration
African cutaneous Kaposi's sarcoma
African lymphadenopathic Kaposi's sarcoma
Iatrogenic (transplant-related) Kaposi's sarcoma (immunosuppression-associated Kaposi's sarcoma)[9][10]


(Epidemic) AIDS-associated Kaposi's sarcoma[11]


References

  1. ↑ Uldrick TS, Whitby D (June 2011). "Update on KSHV epidemiology, Kaposi Sarcoma pathogenesis, and treatment of Kaposi Sarcoma". Cancer Lett. 305 (2): 150–62. doi:10.1016/j.canlet.2011.02.006. PMID 21377267.
  2. ↑ Krigel RL, Laubenstein LJ, Muggia FM (June 1983). "Kaposi's sarcoma: a new staging classification". Cancer Treat Rep. 67 (6): 531–4. PMID 6861160.
  3. ↑ Grayson W, Pantanowitz L (July 2008). "Histological variants of cutaneous Kaposi sarcoma". Diagn Pathol. 3: 31. doi:10.1186/1746-1596-3-31. PMC 2526984. PMID 18655700.
  4. ↑ Vincenzi B, D'Onofrio L, Frezza AM, Grasso RF, Fausti V, Santini D; et al. (2015). "Classic Kaposi Sarcoma: to treat or not to treat?". BMC Res Notes. 8: 138. doi:10.1186/s13104-015-1076-1. PMC 4395989. PMID 25889316.
  5. ↑ Stratigos, John; Potouridou, Irene; Katoulis, Alexander; Hatziolou, Eftichia; Christofidou, Eleftheria; Stratigos, Alexander; Hatzakis, Angelos; Stavrianeas, Nicholas (1997). "Classic Kaposi's sarcoma in Greece: a clinico-epidemiological profile". International Journal of Dermatology. 36 (10): 735–740. doi:10.1046/j.1365-4362.1997.00284.x. ISSN 0011-9059.
  6. ↑ Landau HJ, Poiesz BJ, Dube S, Bogart JA, Weiner LB, Souid AK (2001). "Classic Kaposi's sarcoma associated with human herpesvirus 8 infection in a 13-year-old male: a case report". Clin Cancer Res. 7 (8): 2263–8. PMID 11489800.
  7. ↑ Cetin, Bulent; Aktas, Bilge; Bal, Oznur; Algin, Efnan; Akman, Tulay; Koral, Lokman; Kaplan, Mehmet Ali; Demirci, Umut; Uncu, Dogan; Ozet, Ahmet (2018). "Classic Kaposi's sarcoma: A review of 156 cases". Dermatologica Sinica. 36 (4): 185–189. doi:10.1016/j.dsi.2018.06.005. ISSN 1027-8117.
  8. ↑ Uldrick TS, Whitby D (2011). "Update on KSHV epidemiology, Kaposi Sarcoma pathogenesis, and treatment of Kaposi Sarcoma". Cancer Lett. 305 (2): 150–62. doi:10.1016/j.canlet.2011.02.006. PMC 3085592. PMID 21377267.
  9. ↑ Siegel JH, Janis R, Alper JC, Schutte H, Robbins L, Blaufox MD (1969). "Disseminated visceral Kaposi's sarcoma. Appearance after human renal homograft operation". JAMA. 207 (8): 1493–6. PMID 4884743.
  10. ↑ Klepp O, Dahl O, Stenwig JT (1978). "Association of Kaposi's sarcoma and prior immunosuppressive therapy: a 5-year material of Kaposi's sarcoma in Norway". Cancer. 42 (6): 2626–30. doi:10.1002/1097-0142(197812)42:6<2626::aid-cncr2820420618>3.0.co;2-7. PMID 728865.
  11. ↑ Thomas S, Sindhu CB, Sreekumar S, Sasidharan PK (2011). "AIDS associated Kaposi's sarcoma". J Assoc Physicians India. 59: 387–9. PMID 21751599.


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