Margolius L, Stein M, Spencer D, Bezwoda W R
Renal Transplant Unit, University of the Witwatersrand, Johannesburg.
S Afr Med J. 1994 Jan;84(1):16-7.
Between August 1966 and December 1989, 989 renal transplant recipients were followed up at the Renal Transplant Unit of Johannesburg Hospital. Seventy-five (7%) patients developed a total of 95 malignancies of which 5 (6%) were Kaposi's sarcoma. All patients received immunosuppressive agents; steroids, azathioprine and/or cyclosporin A. Clinical presentations included both limited skin involvement (1 patient) and disseminated forms of the disease: necrotic oral lesions (1 patient); disseminated skin involvement and lung metastases (1 patient); and widespread skin lesions with lymphadenopathy (2 patients). Four patients responded with complete tumour regression at all sites upon withdrawal of the immunosuppressive drugs. One patient suffered disease progression, and immunosuppression was continued, albeit at reduced dosages. These cases illustrate a relatively rare complication of immunosuppressive therapy. However, complete withdrawal of immunosuppressive drugs may result in sustained complete regression, despite the presence of advanced KS.
1966年8月至1989年12月期间，约翰内斯堡医院肾脏移植科对989名肾移植受者进行了随访。75名（7%）患者共发生95例恶性肿瘤，其中5例（6%）为卡波西肉瘤。所有患者均接受免疫抑制剂治疗，包括类固醇、硫唑嘌呤和/或环孢素A。临床表现既有局限性皮肤受累（1例患者），也有疾病的播散形式：坏死性口腔病变（1例患者）；皮肤播散性受累及肺转移（1例患者）；广泛皮肤病变伴淋巴结病（2例患者）。4例患者在停用免疫抑制药物后所有部位的肿瘤均完全消退。1例患者病情进展，继续进行免疫抑制治疗，尽管剂量有所减少。这些病例说明了免疫抑制治疗一种相对罕见的并发症。然而，尽管存在晚期卡波西肉瘤，但完全停用免疫抑制药物可能会导致肿瘤持续完全消退。
