Background. Systemic chemotherapy is a treatment modality in the management of epidemic Kaposi's sarcoma (EKS). We conducted a prospective trial to compare bleomycin as a single agent with a regimen of low-dose doxorubicin, bleomycin, and vincristine (ABV) in patients with advanced EKS.

Methods. Twenty-four homosexual or bisexual patients, between 21 and 40 years old, with positive enzyme-linked Immunosorbent assay (ELISA) test for HIV and extensive EKS were included in the study. Half of the patients received bleomycin alone and the other half ABV.

Results. A total of seven patients achieved stable disease (SD) and five progressed during bleomycin treatment. A total of four patients achieved partial remission and eight SD during ABV treatment. There was no survival benefit between either arm of treatment.

Conclusions. Bleomycin alone is not a good starting agent for EKS, whereas ABV seems to be a good choice, because it can produce an acceptable palliation of advanced EKS without major toxicity.