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Heterogeneity of epidemic Kaposi's sarcoma. Implications for therapy
Author(s) -
Mitsuyasu Ronald T.,
Taylor Jeremy M. G.,
Glaspy John,
Fahey John L.
Publication year - 1986
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19860415)57:8+<1657::aid-cncr2820571304>3.0.co;2-n
Subject(s) - medicine , sarcoma , disease , immune system , kaposi's sarcoma , immunology , stage (stratigraphy) , immunopathology , immunity , cellular immunity , pathogenesis , pathology , biology , paleontology , human herpesvirus
Kaposi's sarcoma (KS) in acquired immune deficiency syndrome (AIDS) is a new manifestation of a previously rare diseaseand generally has a fatal course. Variations in the clinical course and in response to treatment by patients with this disease suggest that specific immunologic or clinical parameters may be important in the prognosis. Retrospective analyses of clinical parameters with respect to survival in 96 patients with epidemic Kaposi's sarcoma indicated that earlier tumor stagethe lack of prior opportunistic infectionsand the absence of systemic symptoms correlated most closely with survival. Sixteen immune parameters were also assessed for their prognostic value. Total T4 (CD‐4) cell number levels and the T4: T8 ratio correlated most closely with survival. Response to treatment with recombinant alpha interferonswhile not well correlated with tumor stagewas more frequent in patients without systemic symptoms or a history of prior opportunistic infections. Treatment response was associated with a greater degree of intact T‐cell function. These findings emphasize the importance of cellular immunity in the pathogenesis and subsequent course of patients with epidemic Kaposi's sarcomasuggesting that different therapeutic strategies may be necessary to address specific prognostic subgroups.