Conflict of interest: Nothing to declare.
Clinical presentation and outcome of epidemic Kaposi sarcoma in Ugandan children†
Article first published online: 4 MAR 2010
Copyright © 2010 Wiley-Liss, Inc.
Pediatric Blood & Cancer
Volume 54, Issue 5, pages 670–674, May 2010
How to Cite
Gantt, S., Kakuru, A., Wald, A., Walusansa, V., Corey, L., Casper, C. and Orem, J. (2010), Clinical presentation and outcome of epidemic Kaposi sarcoma in Ugandan children. Pediatr. Blood Cancer, 54: 670–674. doi: 10.1002/pbc.22369
- Issue published online: 4 MAR 2010
- Article first published online: 4 MAR 2010
- Manuscript Accepted: 23 OCT 2009
- Manuscript Received: 15 AUG 2009
- National Institutes of Health. Grant Numbers: 1 KL2 RR 025015-01, K23 AI 054162-05S1, K24 AI-071113, 5 P01 AI030731-17
- epidemic Kaposi sarcoma;
- human herpesvirus 8;
Kaposi sarcoma (KS) is one of the most common pediatric cancers in sub-Saharan Africa. Few data are available about the clinical presentation or response to treatment of children with epidemic (HIV-associated) KS.
Medical records of all children with KS and HIV infection referred to the Uganda Cancer Institute in Kampala, Uganda from October 2004 to June 2007 were reviewed. Charts were abstracted for age, sex, location of KS lesions at presentation, biopsy results, CD4 T-cell count and percentage, and KS treatment and outcome.
Seventy-three children with epidemic KS were identified, 37 males and 36 females. The median age was 10.1 years (range 2–18). KS presented with lymph node (LN) involvement in 60% of cases. The median absolute and percentage CD4 T-cells at presentation were 210 cells/µl and 7.4%, respectively. Those children with lymphadenopathic KS were younger (mean difference 3.7 years; P = 0.01) and had higher CD4 T-cell counts (mean difference 242 cells/µl; P = 0.03) than those without LN involvement. Of 32 patients for whom outcome data were available, a complete response to chemotherapy and/or antiretroviral therapy was documented in 20 (62.5%) patients.
In comparison to cutaneous involvement, LN involvement of epidemic KS occurs at younger ages and at higher CD4 levels. This clinical presentation may reflect recent infection with human herpesvirus 8 followed by a rapid progression to malignancy. Favorable response to treatment was observed in the majority of cases, but prospective studies are needed to determine optimal management. Pediatr Blood Cancer 2010;54:670–674. © 2010 Wiley-Liss, Inc.