Kaposi’s Sarcoma

  • Camille Francøs
  • Cùleste Lebbù
Part of the Cancer Treatment and Research book series (CTAR, volume 146)

Herpesviruses are double-stranded DNA viruses that can remain latent in vertebrate hosts. Eight human herpesviruses have been discovered to date. Herpesviruses are classified into three subfamilies, a, ß, and ? , on the basis of their genome structure and biological properties. Kaposi’s sarcoma-associated virus (KSHV), also known as human herpesvirus 8 (HHV8), is a gamma herpesvirus (rhadinovirus) closely related to Epstein–Barr virus (EBV) and in the lineage of various rhadinoviruses infecting macaques, African green monkeys (Fig. 1). It was discovered in 1994 by Chang et al. [1] in a Kaposi’s sarcoma (KS) specimen from an human immunodeficiency virus (HIV)-infected patient using representational difference analysis and was shown to be the long-sought infectious agent responsible for KS. Since then, its association has been confirmed in all clinical settings of KS and was extended to a limited number of lymphoproliferations including multicentric Castleman’s disease and primary effusion lymphoma (PEL) [2].


Transplant Recipient Liver Transplant Recipient Organ Transplant Recipient Primary Effusion Lymphoma Cincinnati Transplant Tumor Registry 
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  1. 1.
    Chang Y, Cesarman E, Pessin MS, Lee F, Culpepper J, Knowles DM, Moore PS. Identification of herpesvirus-like DNA sequences in AIDS-associated Kaposi’s sarcoma. Science 1994; 266:1865–9.PubMedCrossRefGoogle Scholar
  2. 2.
    Farge D, and the collaborative transplantation research group of Ile de France. Kaposi’s sarcoma in organ transplant recipients. Eur J Med 1993; 2:339–43.Google Scholar
  3. 3.
    Garcia-Astudillo L, Leyva-Cobian F. Human herpes-virus-8 infection and Kaposi’s sarcoma after liver and kidney transplantation in different geographical areas of Spain. Transplant Immunol 2006; 17:65–9.CrossRefGoogle Scholar
  4. 4.
    Serraino D, Angeletti C, Carrieri MP, Longo B, Piche M, Piselli P, Piselli P, Arbustini E et al. Kaposi’s sarcoma in transplant and HIV-infected patients: an epidemiologic study in Italy and France. Transplantation 2005; 80:1699–704.PubMedCrossRefGoogle Scholar
  5. 5.
    Serraino D, Piselli P, Angeletti C, Minetti E, Pozzetto A, Civati G, Brelleli S et al. Risk of Kaposi’s sarcoma and other cancers in Italian renal transplant patients. Br J Cancer 2005; 92:572–5.PubMedGoogle Scholar
  6. 6.
    Qunibi WY, Barri Y, Aifurayh O, Almeshari K, Khan B, Taher S, Sheth K. Kaposi’s sarcoma in renal transplant recipients: a report on 26 cases from a single institution. Transplant Proc 1993; 25:1402–5.PubMedGoogle Scholar
  7. 7.
    Margolius L, Stein M, Spencer D, Bezwoda WR. Kaposi’s sarcoma in renal transplant recipients. Experience at Johannesburg Hospital, 1966–1989. S Afr Med J 1994; 84:16–7.Google Scholar
  8. 8.
    Shmueli D, Shapira Z, Yussim A, Nakache R, Ram Z, Shaharabani E. The incidence of Kaposi’s sarcoma in renal transplant patients and its relation to immunosuppression. Transplant Proc 1989; 21:3209–10.PubMedGoogle Scholar
  9. 9.
    Zahger D, Lotan C, Admond D, Klapholz L, Kaufman B, Shimon D, Woolfson N, Gotsman MS. Very early appearance of Kaposi’s sarcoma after cardiac transplantation in Sephardic Jews. Am Heart J 1993; 126:999–1000.PubMedCrossRefGoogle Scholar
  10. 10.
    Mbulaitey SM, Engels EA. Kaposis’s sarcoma risk among transplant recipients in the United States (1993–2003). Int J Cancer 2006; 119:2685–91.CrossRefGoogle Scholar
  11. 11.
    Frezza EE, Fung JJ, van Thiel DH. Non-lymphoid cancer after liver transplantation. Hepatogastroenterology 1997; 44:1172–81.PubMedGoogle Scholar
  12. 12.
    Shepherd FA, Maher E, Cardella C, Cole E, Greig P, Wade JA, Levy G. Treatment of Kaposi sarcoma after solid organ transplantation. J Clin Oncol 1997; 15:2371–7.PubMedGoogle Scholar
  13. 13.
    Penn I. Sarcomas in organ allografts recipients. Transplantation 1995; 60:1485–91.PubMedCrossRefGoogle Scholar
  14. 14.
    Harwood AR, Osoba D, Hofstader SL, Goldstein MB, Cardella CJ, Holecek MJ, Kunynetz R, Giammarco RA. Kaposi’s sarcoma in recipients of renal transplants. Am J Med 1979; 67:759–65.PubMedCrossRefGoogle Scholar
  15. 15.
    Euvrard S, Kanitakis J, Claudy A. Skin cancers after organ transplantation. N Engl J Med 2003; 348:1681–91.PubMedCrossRefGoogle Scholar
  16. 16.
    Woodle E, Hanaway M, Buell J, Gross T, First MR, Trofe J, Beebe T; Israel Penn International Transplant Tumor Registry. Kaposi’s sarcoma: an analysis of the US and international experiences from the Israel Penn International Transplant Tumor Registry. Transplant Proc 2001; 33:3660–1.PubMedCrossRefGoogle Scholar
  17. 17.
    Marcelin AG, Calvez V, Dussaix E. KSHV after an organ transplant: should we screen? Curr Top Microbiol Immunol 2007; 312:245–62.PubMedCrossRefGoogle Scholar
  18. 18.
    Cattani P, Capuano M, Graffeo R, Ricci R, Cerimele F, Cerimele D, Nanni G, Fadda G. Kaposi’s sarcoma associated with previous human herpesvirus 8 infection in kidney. J Clin Microbiol 2001; 39:506–8.PubMedCrossRefGoogle Scholar
  19. 19.
    Francès C, Mouquet C, Marcelin AG, Barete S, Agher R, Charron D, Benalia H et al. Outcome of kidney transplant recipients with previous human herpesvirus-8 infection. Transplantation 2000; 69:1776–9.PubMedCrossRefGoogle Scholar
  20. 20.
    Andreoni M, Goletti D, Pezzotti P, Monini P, Sarmati L, Farchi T et al. Prevalence, incidence and correlates of HHV-8/KSHV infection and Kaposi’s sarcoma in renal and liver transplant recipients. J Infect 2001; 43:195–9.PubMedCrossRefGoogle Scholar
  21. 21.
    Marcelin AG, Roque-Afonso AM, Hurtova M, Dupin N, Tulliez M, Sebagh M, Arkoub ZA et al. Fatal disseminated Kaposi’s sarcoma following human herpesvirus 8 primary infections in liver-transplant recipients. Liver Transplant 2004; 10:295–300.CrossRefGoogle Scholar
  22. 22.
    Aseni P, Vertemati M, Minola E, Arcieri K, Bonacina E, Camozzi M, Osio C et al. Kaposi’s sarcoma in liver transplant recipients: morphological and clinical description. Liver Transplant 2001; 7:816–23.CrossRefGoogle Scholar
  23. 23.
    Edmond JP, Marcellin AG, Dorent R, Milliancourt C, Dupin N, Frances C, Agut H, Gandjbakhch I, Calvez V. Kaposi’s sarcoma associated with previous human herpesvirus 8 infection in heart transplant recipients. J Clin Microbiol 2002; 40:2217–9.CrossRefGoogle Scholar
  24. 24.
    Sachsenberg-Studer EM, Dobrynski N, Sheldon J, Schulz TF, Pechere M, Nadore RG, Spiliopoulos A et al. Human herpes-virus 8 seropositive patient with skin and graft Kaposi’s sarcoma after lung transplantation. J Am Acad Dermatol 1999; 40:308–11.PubMedCrossRefGoogle Scholar
  25. 25.
    Barozzi P, Luppi M, Facchetti F, Mecucci G, Alu M, Sarid R, Rasini V et al. Post-transplant Kaposi’s sarcoma originates from the seeding of donor-derived progenitors. Nat Med 2003; 9:554–61.PubMedCrossRefGoogle Scholar
  26. 26.
    Marcelin AG, Roque-Afonso AM, Hurtova M, Dupin N, Tulliez M, Sebagh M, Arkoub ZA, et al. Fatal disseminated Kaposi’s sarcoma following human herpesvirus 8 primary infections in liver-transplant recipients. Liver Transplant 2004; 10:295–300.CrossRefGoogle Scholar
  27. 27.
    Regamey N, Tamm M, Wernli M, Witschi A, Thiel G, Cathomas G, Erb P. Transmission of human herpesvirus 8 infection from renal-transplant donors to recipients. N Engl J Med 1998; 339:1358–63.PubMedCrossRefGoogle Scholar
  28. 28.
    Milliancourt C, Barete S, Marcelin AG, Mouquet C, Dupin N, Frances C, Agut H, Bitker MO, Calvez V. Human herpes-virus-8 seroconversions after renal transplantation. Transplantation 2001; 72:1319–20.PubMedCrossRefGoogle Scholar
  29. 29.
    Micali G, Gasparri O, Nasca MR, Sapuppo A. Kaposi’s sarcoma occurring de novo in the surgical scar in a heart transplant recipient. J Am Acad Dermatol 1992; 27:273–4.PubMedCrossRefGoogle Scholar
  30. 30.
    Barete S, Calvez V, Mouquet C, Barrou B, Kreis H, Dantal J, Dorent R, Durand F, Dimitrov Y, Dupin N, Marcelin AG, Piette JC, Bitker MO, Frances C. Kaposi’s sarcoma in organ allograft recipients: clinical features and contribution of virological findings for the management of the disease. Arch Dermatol 2000; 136:1452–6.PubMedCrossRefGoogle Scholar
  31. 31.
    Quniby WY, Akhtar M, Ginn E, Smith P. Kaposi sarcoma in cyclosporin-induced gingival hyperplasia. Am J Kidney Dis 1988; 11:349–2.Google Scholar
  32. 32.
    Lopes P, Petit T, Audoin AF, Lenne Y. Sarcome de Kaposi du col utérin chez une transplantée cardiaque (lettre). Presse Med 1988; 17:1539.PubMedGoogle Scholar
  33. 33.
    Frances C. Kaposi’s sarcoma after renal transplantation. Nephrol Dial Transplant 1998; 13:2368–73.CrossRefGoogle Scholar
  34. 34.
    Restrepo CS, Martinez S, Lemos JO, Carrillo JA, Lemos DF, Ojeda P, Koshy P. Imaging manifestations of Kaposi’s sarcoma. Radiographics 2006; 26:1169–85.PubMedCrossRefGoogle Scholar
  35. 35.
    Dupin N, Fisher C, Kellam P, Ariad S, Tulliez M, Franck N, et al. Distribution of human herpesvirus-8 latently infected cells in Kaposi’s sarcoma, multicentric Castleman’s disease, and primary effusion lymphoma. Proc Natl Acad Sci U S A 1999; 96:4546–51.PubMedCrossRefGoogle Scholar
  36. 36.
    Gill PS, Tsai YC, Rao AP, Spruck CH 3rd, Zheng T, Harrington WA, Cheung T Jr, Nathwani B, Jones PA. Evidence for multiclonality in multicentric Kaposi’s sarcoma. Proc Natl Acad Sci USA 1998; 95:8257–61.PubMedCrossRefGoogle Scholar
  37. 37.
    Klass CM, Offerman MK. Targeting human herpesvirus-8 for treatment of Kaposi’s sarcoma and primary effusion lymphoma. Curr Opin Oncol 2005; 17:447–55.PubMedCrossRefGoogle Scholar
  38. 38.
    Pellet C, Chevret S, Francès C, Euvrard S, Hurault M, Legendre C, Dalac S, et al. Prognostic value of quantitative Kaposi sarcoma-associated herpes virus load in posttransplantation Kaposi sarcoma. J Infect Dis 2002; 186:110–3.PubMedCrossRefGoogle Scholar
  39. 39.
    Al-Khader AA, Suleiman M, Al-Hasani M, Haleem A. Posttransplant Kaposi’s sarcoma: staging as a guide to therapy and prognosis. Nephron 1988; 48:165.PubMedCrossRefGoogle Scholar
  40. 40.
    Stallone G, Schena A, Infante B, Di Paolo S, Loverre A, Maggio G, Ranieri E, et al. Sirolimus for Kaposi’s sarcoma in renal-transplant recipients. N Engl J Med 2005; 352:1317–23.PubMedCrossRefGoogle Scholar
  41. 41.
    Campistol JM, Gutierrez-Dalmau A, Torregrosa JV. Conversion to sirolimus: a successful treatment for posttransplantation Kaposi’s sarcoma. Tranplantation 2004; 77:760–2.CrossRefGoogle Scholar
  42. 42.
    Gutierrez-Dalmau A, Sanchez-Fructuoso A, Sanz-Guajardo A, Mazuecos A, Franco A, Rial MC, Iranzo P. Efficacy of conversion to sirolimus in posttransplantation Kaposi’s sarcoma. Tranplant Proc 2005; 37:3836–8.CrossRefGoogle Scholar
  43. 43.
    Boeckle E, Boesmueller C, Wiesmayr S, Mark W, Rieger M, Tabarelli D, Graziadei I, et al. Kaposi’s sarcoma in solid organ transplant recipients: a single center report. Transplant Proc 2005; 37:1905–9.PubMedCrossRefGoogle Scholar
  44. 44.
    Zmonarski SC, Boratynska M, Rabczynski J, Kazimierczak K, Klinger M. Regression of Kaposi’s sarcoma in renal graft recipients after conversion to sirolimus treatment. Transplant Proc 2005; 37:964–6.PubMedCrossRefGoogle Scholar
  45. 45.
    Mohsin N, Budruddin M, Pakkyara A, Darweesh A, Nayyer M, Amitabh J, Daar AS. Complete regression of visceral Kaposi’s sarcoma after conversion to sirolimus. Exp Clin Transplant 2005; 3:366–9.PubMedGoogle Scholar
  46. 46.
    Lebbe C, Euvrard S, Barrou B, Pouteil-Noble C, Garnier JL, Glotz D, Legendre C, Frances C. Sirolimus conversion for patients with posttransplant Kaposi’s sarcoma. Am J Transplant 2006; 6:2164–8.PubMedCrossRefGoogle Scholar
  47. 47.
    Campistol JM, Schena FP. Kaposi’s sarcoma in renal transplant recipients: the impact of proliferation signal inhibitors. Nephrol Dial Transplant 2007; 22(suppl 1): i17–i22.PubMedCrossRefGoogle Scholar
  48. 48.
    Boratynska M, Zmonarski SC, Klinger M. Recurrence of Kaposi’s sarcoma after increased exposure to sirolimus. Int Immunopharmacol 2006; 6:2018–22.PubMedCrossRefGoogle Scholar
  49. 49.
    Wasywich CA, Croxson MC, van Doornum GJ, Coverdale HA, Ruygrok PN. Sirolimus for Kaposi’s sarcoma. J Heart Lung Transplant 2006; 25:726–9.PubMedCrossRefGoogle Scholar
  50. 50.
    Descoeudres B, Giannini O, Graf T, Steiger J, Mayr M. No effect of sirolimus for Kaposi sarcoma in a renal transplant recipient. Transplantation 2006; 81:1472–4.PubMedCrossRefGoogle Scholar
  51. 51.
    Di Paolo S, Teutonico A, Ranieri E, Gesualdo L, Schena PF. Monitoring antitumor efficacy of rapamycin in Kaposi sarcoma. Am J Kidney Dis 2007; 49:462–70.PubMedCrossRefGoogle Scholar
  52. 52.
    Magnone M, Holley J, Shapiro R, Scantelbury V, McCauley J, Jordan M, Vivas C, Starzl T, Johnson J. Interferon-α induced acute renal allograft rejection. Transplantation 1994; 59:1068–70.CrossRefGoogle Scholar
  53. 53.
    Wright WHL, Galaver JS, Van Thiel DH. Preliminary experience with alpha-2b-interferon therapy of viral hepatitis in liver allograft recipients. Transplantation 1994; 53:121–4.CrossRefGoogle Scholar
  54. 54.
    Halmos O, Inturri P, Galligioni A, Di Landro D, Rigotti P, Tedeschi U, Graziotto A, Burra P, Poletti A, Rossaro L. Two cases of Kaposi’s sarcoma in renal and liver transplant recipients treated with interferon. Clin Transplant 1996; 10: 374–8.PubMedGoogle Scholar
  55. 55.
    Euvrard S, Kanitakis J, Bosshard S, Lebbe C, Garnier JL, Touraine JL, Claudy A. No recurrence of posttransplantation Kaposi’s sarcoma three years after renal retransplantation. Transplantation 2002; 73:297–9.PubMedCrossRefGoogle Scholar
  56. 56.
    Segoloni GP, Giraudi R, Messina M, Rossetti M, Biancone L, Leonardi G, Piccoli GB, Magnano A, Gai M. No recurrence of Kaposi’s sarcoma in a case of renal retransplantation under a calcineurin inhibitor free immunosuppressive regimen: first report. Transplant Int 2007; 20:395–6.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Camille Francøs
    • 1
  • Cùleste Lebbù
    • 2
  1. 1.Department of DermatologyAPHP Hospital Tenon ParisFrance
  2. 2.Department of DermatologyAPHP Hospital Saint LouisFrance

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