Pathology of rituximab-induced Kaposi sarcoma flare

BACKGROUND: Kaposi sarcoma (KS) flare may occur following therapy with corticosteroids, as part of the immune reconstitution inflammatory syndrome seen with highly active antiretroviral therapy (HAART), and after rituximab therapy. The exact mechanism responsible for iatrogenic KS flare is unclear....

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Autores principales: Pantanowitz, Liron, Früh, Klaus, Marconi, Sharon, Moses, Ashlee V, Dezube, Bruce J
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2008
Materias:
Research Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2515841/
https://www.ncbi.nlm.nih.gov/pubmed/18651955
http://dx.doi.org/10.1186/1472-6890-8-7
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author Pantanowitz, Liron
Früh, Klaus
Marconi, Sharon
Moses, Ashlee V
Dezube, Bruce J
author_facet Pantanowitz, Liron
Früh, Klaus
Marconi, Sharon
Moses, Ashlee V
Dezube, Bruce J
author_sort Pantanowitz, Liron
collection PubMed
description BACKGROUND: Kaposi sarcoma (KS) flare may occur following therapy with corticosteroids, as part of the immune reconstitution inflammatory syndrome seen with highly active antiretroviral therapy (HAART), and after rituximab therapy. The exact mechanism responsible for iatrogenic KS flare is unclear. METHODS: A case of AIDS-associated cutaneous KS flare following rituximab therapy was compared to similar controls by means of immunohistochemistry using vascular makers (CD34, CD31), monoclonal antibodies to Human Herpesvirus 8 (HHV8) gene products (LNA-1, K5), as well as B-lymphocyte (CD20) and T-lymphocyte (CD3, CD4, CD8) markers. RESULTS: CD20+ B-cell depletion with rituximab in KS flare occurred concomitantly with activation of the HHV8 immediate early gene protein K5. KS flare in this patient was successfully treated with liposomal doxorubicin and valganciclovir. CONCLUSION: Rituximab-induced KS flare appears to be related to HHV8 activation. Effective management of iatrogenic KS flare therefore depends upon the control of HHV8 viremia in conjunction with specific chemotherapy for KS.
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spelling pubmed-25158412008-08-14 Pathology of rituximab-induced Kaposi sarcoma flare Pantanowitz, Liron Früh, Klaus Marconi, Sharon Moses, Ashlee V Dezube, Bruce J BMC Clin Pathol Research Article BACKGROUND: Kaposi sarcoma (KS) flare may occur following therapy with corticosteroids, as part of the immune reconstitution inflammatory syndrome seen with highly active antiretroviral therapy (HAART), and after rituximab therapy. The exact mechanism responsible for iatrogenic KS flare is unclear. METHODS: A case of AIDS-associated cutaneous KS flare following rituximab therapy was compared to similar controls by means of immunohistochemistry using vascular makers (CD34, CD31), monoclonal antibodies to Human Herpesvirus 8 (HHV8) gene products (LNA-1, K5), as well as B-lymphocyte (CD20) and T-lymphocyte (CD3, CD4, CD8) markers. RESULTS: CD20+ B-cell depletion with rituximab in KS flare occurred concomitantly with activation of the HHV8 immediate early gene protein K5. KS flare in this patient was successfully treated with liposomal doxorubicin and valganciclovir. CONCLUSION: Rituximab-induced KS flare appears to be related to HHV8 activation. Effective management of iatrogenic KS flare therefore depends upon the control of HHV8 viremia in conjunction with specific chemotherapy for KS. BioMed Central 2008-07-23 /pmc/articles/PMC2515841/ /pubmed/18651955 http://dx.doi.org/10.1186/1472-6890-8-7 Text en Copyright © 2008 Pantanowitz et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Pantanowitz, Liron
Früh, Klaus
Marconi, Sharon
Moses, Ashlee V
Dezube, Bruce J
Pathology of rituximab-induced Kaposi sarcoma flare
title Pathology of rituximab-induced Kaposi sarcoma flare
title_full Pathology of rituximab-induced Kaposi sarcoma flare
title_fullStr Pathology of rituximab-induced Kaposi sarcoma flare
title_full_unstemmed Pathology of rituximab-induced Kaposi sarcoma flare
title_short Pathology of rituximab-induced Kaposi sarcoma flare
title_sort pathology of rituximab-induced kaposi sarcoma flare
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2515841/
https://www.ncbi.nlm.nih.gov/pubmed/18651955
http://dx.doi.org/10.1186/1472-6890-8-7
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