Observational studyPloS one2016
Clinical Factors Associated with Long-Term Complete Remission versus Poor Response to Chemotherapy in HIV-Infected Children and Adolescents with Kaposi Sarcoma Receiving Bleomycin and Vincristine: A Retrospective Observational Study.
Observational study in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
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Who cites it
28 citing papers in PubMed, 38 citations in OpenAlex.
- Relapse patterns among children and adolescents with Kaposi sarcoma in Malawi.Pediatric hematology and oncology · 2025Article
- Hypoxia-driven angiogenesis and metabolic reprogramming in vascular tumors.Frontiers in cell and developmental biology · 2025Review
- Unraveling Skin Carcinoma: A Comprehensive Examination of Diagnosis, Treatment Strategies, and Emerging Therapeutic Avenues in Skin Cancer Management.Pharmaceutical nanotechnology · 2025Review
- Review
- Tumor-Associated Edema in Children with Kaposi Sarcoma: 14 Years' Experience at Kamuzu Central Hospital, Lilongwe, Malawi.Cancers · 2024Article
- Update on pathology laboratory development and research in advancing regional cancer care in Malawi.Frontiers in medicine · 2024Article
- Pediatric HIV+ Kaposi sarcoma exhibits clinical, virological, and molecular features different from the adult disease.JCI insight · 2023Article
- Divergent clinical presentations and outcomes among children and adolescents with Kaposi sarcoma in Malawi and Tanzania.HIV medicine · 2023Article
- Endemic Kaposi's Sarcoma.Cancers · 2023Review
- Effective treatment of HIV-associated Kaposi sarcoma in the setting of immune-reconstitution inflammatory syndrome using intralesional bleomycin.JAAD case reports · 2022Article
- Topical treatments for Kaposi sarcoma: A systematic review.Skin health and disease · 2022Article
- Long-term outcomes for children and adolescents with Kaposi sarcoma.HIV medicine · 2022Article
- Use of Paclitaxel to Successfully Treat Children, Adolescents, and Young Adults with Kaposi Sarcoma in Southwestern Tanzania.Children (Basel, Switzerland) · 2021Article
- Kaposi's sarcoma-associated herpesvirus protein ORF75 among HIV-1 patients in Kenya.African journal of laboratory medicine · 2020Article
- Navigating the heterogeneous landscape of pediatric Kaposi sarcoma.Cancer metastasis reviews · 2019Review
- Kaposi Sarcoma Herpesvirus Inflammatory Cytokine Syndrome-like Clinical Presentation in Human Immunodeficiency Virus-infected Children in Malawi.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Article
- KSHV viral load and Interleukin-6 in HIV-associated pediatric Kaposi sarcoma-Exploring the role of lytic activation in driving the unique clinical features seen in endemic regions.International journal of cancer · 2019Observational
- Three year survival among patients with aids-related Kaposi sarcoma treated with chemotherapy and combination antiretroviral therapy at Moi teaching and referral hospital, Kenya.Infectious agents and cancer · 2019Article
- Proposal of a Risk-Stratification Platform to Address Distinct Clinical Features of Pediatric Kaposi Sarcoma in Lilongwe, Malawi.Journal of global oncology · 2018Article
- Cancer in adolescents and young adults living with HIV.Current opinion in HIV and AIDS · 2018Review
Corrections and comments
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Authors and funding
12 authors at 6 institutions in 1 country.
Funding
Abstract
Kaposi sarcoma (KS) is the most common HIV-associated malignancy in children and adolescents in Africa. Pediatric KS is distinct from adult disease. We evaluated the clinical characteristics associated with long-term outcomes. We performed a retrospective observational analysis of 70 HIV-infected children and adolescents with KS less than 18 years of age diagnosed between 8/2010 and 6/2013 in Lilongwe, Malawi. Local first-line treatment included bleomycin and vincristine plus nevirapine-based highly active anti-retroviral therapy (HAART). Median age was 8.6 years (range 1.7-17.9); there were 35 females (50%). Most common sites of presentation were: lymph node (74%), skin (59%), subcutaneous nodules (33%), oral (27%), woody edema (24%), and visceral (16%). Eighteen (26%) presented with lymphadenopathy only. Severe CD4 suppression occurred in 28%. At time of KS diagnosis, 49% were already on HAART. Overall, 28% presented with a platelet count < 100 x 109/L and 37% with hemoglobin < 8 g/dL. The 2-year event-free (EFS) and overall survival (OS) were 46% and 58% respectively (median follow-up 29 months, range 15-50). Multivariable analysis of risk of death and failure to achieve EFS demonstrated that visceral disease (odds ratios [OR] 19.08 and 11.61, 95% CI 2.22-163.90 and 1.60-83.95 respectively) and presenting with more than 20 skin/oral lesions (OR 9.57 and 22.90, 95% CI 1.01-90.99 and 1.00-524.13 respectively) were independent risk factors for both. Woody edema was associated with failure to achieve EFS (OR 7.80, 95% CI 1.84-33.08) but not death. Univariable analysis revealed that lymph node involvement was favorable for EFS (OR 0.28, 95% CI 0.08-0.99), while T1 TIS staging criteria, presence of cytopenias, and severe immune suppression were not associated with increased mortality. Long-term complete remission is achievable in pediatric KS, however outcomes vary according to clinical presentation. Based on clinical heterogeneity, treatment according to risk-stratification is necessary to improve overall outcomes.
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