regression of post-transplant kaposi′s sarcoma after replacing cyclosporine with mycophenolate mofetil

Abstract

Kaposi′s sarcoma (KS) has been recently linked with human herpes virus-8 (HHV-8) infection. Other risk factors include the use of cyclosporine and polyclonal anti-lymphocyte sera. Reduction of the immunosuppression, in particular cyclosporine, leads to regression or disappearance of the tumor in a significant number of patients. There are few publications about the response of the tumor to the newer immunosuppressive agent mycophenolate mofetil (MMF). We describe here a 52-year-old woman, who developed KS 22 months after living related transplantation. The sarcoma lesions disappeared after replacing cyclosporine and azathioprine by MMF, while the allograft function remained stable. This case suggests the importance of discontinuation of cyclosporine in the treatment of post-transplant KS. MMF, while maintaining allograft function in the absence of cyclosporine, apparently did not interfere with the regression of the tumor.