scholarly journals Therapeutic Outcomes in AIDS-Associated Kaposi's Sarcoma Patients on Antiretroviral Therapy Treated with Chemotherapy at Two Tertiary Hospitals in Lusaka, Zambia

2018 ◽  
Vol 16 (3) ◽  
pp. 231-236 ◽  
Author(s):  
Watson Mtonga ◽  
Aaron Mujajati ◽  
Derick Munkombwe ◽  
Aubrey Kalungia ◽  
Lungwani Tyson Muungo ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Kaposi's Sarcoma ◽  
Kaposi’S Sarcoma ◽  
Complete Response ◽  
University Teaching ◽  
Teaching Hospitals ◽  
Recurrence Rates ◽  
Therapeutic Outcomes ◽  
Efficacious Treatment ◽  
Study Participants

The incidence of HIV-associated Kaposi’s sarcoma (KS) remains high in Zambia in the antiretroviral therapy era. The most efficacious treatment regimen for KS has yet to be established. In both developed and developing countries, treatment regimens have had limited efficacy. Late presentation in Africa affects therapeutic outcomes. Objective: The aim of this study was to determine therapeutic outcomes of epidemic KS patients on combination antiretroviral therapy (cART) after completion of six cycles of Adriamycin, Bleomycin, and Vincristine (ABV) chemotherapy. Methods: This was a descriptive cross-sectional study. Study participants were drawn from a study database of confirmed incident KS patients seen at the Skin Clinic of the University Teaching Hospitals (UTH) during the period between August, 2015 and September, 2016. Results: Of the 38 successfully recruited study participants, a complete response was documented in 18 (47%) after 6 cycles of ABV whereas 20 (53%) experienced a partial response. KS recurrence was observed in 8 (44%) of the individuals that experienced an initial complete response. At the time of the study, clinical assessment revealed that KS lesions had completely regressed in 21 (55%) of all the patients. Conclusion: ABV chemotherapy appears ineffective in long-term resolution of epidemic KS patients on ART. Recurrence rates are high after chemotherapy in patients that experience initially favorable responses to treatment. There is a need to diagnose KS earlier, and to develop more efficacious treatment options in order to reduce recurrence rates for epidemic KS.

Therapeutic Outcomes in AIDS-Associated Kaposi's Sarcoma Patients on Antiretroviral Therapy Treated with Chemotherapy at Two Tertiary Hospitals in Lusaka, Zambia

2020 ◽  
Author(s):  
Lungwani Muungo
Keyword(s):  
Antiretroviral Therapy ◽  
Kaposi's Sarcoma ◽  
Kaposi’S Sarcoma ◽  
Complete Response ◽  
University Teaching ◽  
Teaching Hospitals ◽  
Recurrence Rates ◽  
Cross Sectional ◽  
Therapeutic Outcomes ◽  
Study Participants

The incidence of HIV-associated Kaposi’s sarcoma (KS) remains high in Zambia in theantiretroviral therapy era. The most efficacious treatment regimen for KS has yet to be established.In both developed and developing countries, treatment regimens have had limited efficacy. Latepresentation in Africa affects therapeutic outcomes.Objective: The aim of this study was to determine therapeutic outcomes of epidemic KS patients oncombination antiretroviral therapy (cART) after completion of six cycles of Adriamycin, Bleomycin,and Vincristine (ABV) chemotherapy.Methods: This was a descriptive cross-sectional study. Study participants were drawn from a studydatabase of confirmed incident KS patients seen at the Skin Clinic of the University Teaching Hospitals(UTH) during the period between August, 2015 and September, 2016.Results: Of the 38 successfully recruited study participants, a complete response was documented in18 (47%) after 6 cycles of ABV whereas 20 (53%) experienced a partial response. KS recurrencewas observed in 8 (44%) of the individuals that experienced an initial complete response. At the timeof the study, clinical assessment revealed that KS lesions had completely regressed in 21 (55%) ofall the patients.Conclusion: ABV chemotherapy appears ineffective in long-term resolution of epidemic KS patientson ART. Recurrence rates are high after chemotherapy in patients that experience initially favorableresponses to treatment. There is a need to diagnose KS earlier, and to develop more efficacioustreatment options in order to reduce recurrence rates for epidemic KS.Keywords: Kaposi’s Sarcoma, HIV-associated, treatment, chemotherapy, outcomes, recurrence.

scholarly journals Phase II Study of Bevacizumab in Patients With HIV-Associated Kaposi's Sarcoma Receiving Antiretroviral Therapy

2012 ◽  
Vol 30 (13) ◽  
pp. 1476-1483 ◽  
Author(s):  
Thomas S. Uldrick ◽  
Kathleen M. Wyvill ◽  
Pallavi Kumar ◽  
Deirdre O'Mahony ◽  
Wendy Bernstein ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Kaposi's Sarcoma ◽  
Kaposi’S Sarcoma ◽  
Complete Response ◽  
Median Number ◽  
Primary Objective ◽  
Cytotoxic Agents ◽  
Prior Chemotherapy ◽  
Highly Active

Purpose Alternatives to cytotoxic agents are desirable for patients with HIV-associated Kaposi's sarcoma (KS). Vascular endothelial growth factor-A (VEGF-A) contributes to KS pathogenesis. We evaluated the humanized anti–VEGF-A monoclonal antibody, bevacizumab, in patients with HIV-KS. Patients and Methods Patients with HIV-KS who either experienced progression while receiving highly active antiretroviral therapy (HAART) for at least 1 month or did not regress despite HAART for at least 4 months were administered bevacizumab 15 mg/kg intravenously on days 1 and 8 and then every 3 weeks. The primary objective was assessment of antitumor activity using modified AIDS Clinical Trial Group (ACTG) criteria for HIV-KS. HIV-uninfected patients were also eligible and observed separately. Results Seventeen HIV-infected patients were enrolled. Fourteen patients had been receiving effective HAART for at least 6 months (median, 1 year). Thirteen patients had advanced disease (ACTG T1), 13 patients had received prior chemotherapy for KS, and seven patients had CD4 count less than 200 cells/μL. Median number of cycles was 10 (range, 1 to 37 cycles); median follow-up was 8.3 months (range, 3 to 36 months). Of 16 assessable patients, best tumor responses observed were complete response (CR) in three patients (19%), partial response (PR) in two patients (12%), stable disease in nine patients (56%), and progressive disease in two patients (12%). Overall response rate (CR + PR) was 31% (95% CI, 11% to 58.7%). Four of five responders had received prior chemotherapy for KS. Over 202 cycles, grade 3 to 4 adverse events at least possibly attributed to therapy included hypertension (n = 7), neutropenia (n = 5), cellulitis (n = 3), and headache (n = 2). Conclusion Bevacizumab is tolerated in patients with HIV-KS and has activity in a subset of patients.

Kaposi Sarcoma of the Lower Extremity with HIV and Kaposi's Sarcoma

2021 ◽  
Vol 2 (1) ◽  
pp. 01-03
Author(s):  
Selma Bakar Dertlioğlu
Keyword(s):  
Antiretroviral Therapy ◽  
Oral Cavity ◽  
Lower Extremity ◽  
Respiratory System ◽  
Kaposi's Sarcoma ◽  
Kaposi Sarcoma ◽  
Kaposi’S Sarcoma ◽  
Newly Diagnosed ◽  
Clinical Variants ◽  
Common Malignancy

Kaposi's sarcoma is the most common malignancy seen with HIV infection. It is a lymphoangioproliferous tumor first described by Moritz Kaposi in 1872. It is characterized by bluish red or dark brown plaques and nodules, especially in the distal of the lower extremities, often the heels and feet. Organ involvement without skin findings is observed in approximately 15% of the cases. There are four clinical variants, the classical, endemic, iatrogenic and the epidemic associated with AIDS. Kaposi's sarcoma in AIDS cases apart from the skin, it can also be seen in the oral cavity, gastro-intestinal system and respiratory system. Antiretroviral therapy (ART) should be started immediately in newly diagnosed HIV infected patients. In this research, a 65 year old male patient, who was diagnosed AIDS and Kaposi's sarcoma at the same time, is described.

Phase II trial with dose titration of paclitaxel for the therapy of human immunodeficiency virus-associated Kaposi's sarcoma.

1998 ◽  
Vol 16 (3) ◽  
pp. 1112-1121 ◽  
Author(s):  
L Welles ◽  
M W Saville ◽  
J Lietzau ◽  
J M Pluda ◽  
K M Wyvill ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Kaposi's Sarcoma ◽  
Single Agent ◽  
Kaposi’S Sarcoma ◽  
Complete Response ◽  
Pulmonary Involvement ◽  
Dose Titration ◽  
Treatment Schedule ◽  
Creatinine Concentration ◽  
Immunodeficiency Virus

PURPOSE To investigate the antitumor activity and safety of paclitaxel in patients with advanced human immunodeficiency virus (HIV)-associated Kaposi's sarcoma (KS). PATIENTS AND METHODS Twenty-nine patients with advanced HIV-associated KS were enrolled. The patients were overall quite immunosuppressed (median CD4 count, 15 cells/microL). Paclitaxel was initially administered at 135 mg/m2 over 3 hours every 3 weeks without filgrastim support; the dose was increased as tolerated to a maximum of 175 mg/m2. Patients who failed to respond or progressed could then receive filgrastim support or paclitaxel administered over 96 hours. RESULTS Of 28 assessable patients, 20 had major responses (18 partial responses [PRs], one clinical complete response [CR], and one CR), for a major response rate of 71.4% (95% confidence interval [CI], 51.3% to 86.8%). Each of the five patients with pulmonary KS responded, as did all four assessable patients who had previously received anthracycline therapy for KS. Of six patients who went on to receive a 96-hour infusion of paclitaxel, five had major responses. Neutropenia was the most frequent dose-limiting toxicity; possible novel toxicities included late fevers, late rash, and eosinophilia. Two patients developed an elevated creatinine concentration and one cardiomyopathy. CONCLUSION Paclitaxel has substantial activity against advanced HIV-associated KS as a single agent, even in patients with pulmonary involvement or who had previously received anthracyclines. Further research is needed to define the optimal treatment schedule and its role vis-a-vis the other available therapies for this disease.

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