Management of Kaposi Sarcoma after Solid Organ Transplantation: a European Retrospective Study

Abstract Background Systemic therapeutic management of post-transplant Kaposi sarcoma (KS) is mainly based on 3 axes: reduction of immunosuppression, conversion to mammalian target of rapamycin (mTOR) inhibitors and/or chemotherapy. Objective To obtain an overview of clinical strategies about the current treatment of KS. Methods We conducted a multicenter retrospective cohort study including 145 solid organ transplant recipients diagnosed with KS between 1985 and 2011 to collect data regarding first-line treatment and response at 6 months. Results Ninety five percent, 28% and 16% of patients had reduction of immunosuppression, conversion to mTOR inhibitor and chemotherapy, respectively. Patients treated with chemotherapy or mTOR inhibitor conversion were more likely to have visceral KS. Overall, 83% of patients had response at 6 months including 40% complete responses (CR). Limitations The retrospective design of the study. Conclusion Currently available therapeutic options seem to be effective to control KS in a majority of patients. Tapering down the immunosuppressive regimen remains the cornerstone of KS management.