PMID- 23487320
OWN - NLM
STAT- MEDLINE
DCOM- 20130827
LR  - 20220330
IS  - 1545-5017 (Electronic)
IS  - 1545-5009 (Linking)
VI  - 60
IP  - 8
DP  - 2013 Aug
TI  - Clinical characteristics and outcomes of HIV-infected children diagnosed with 
      Kaposi sarcoma in Malawi and Botswana.
PG  - 1274-80
LID - 10.1002/pbc.24516 [doi]
AB  - BACKGROUND: Kaposi sarcoma (KS) is the most common HIV-associated malignancy in 
      sub-Saharan Africa. The presentation and outcomes of pediatric KS are not well 
      understood. PROCEDURE: We performed a retrospective cohort analysis of 81 
      HIV-infected children with KS at the Baylor Children's Clinical Centres of 
      Excellence in Malawi and Botswana from March 2003 to October 2009. RESULTS: 
      Eighty-one children with KS were identified whose median age was 8.0 
      (inter-quartile range 5.1-11.3) years. KS lesions were presented primarily on the 
      skin (83%), lymph nodes (52%), and oral mucosa (41%). Occasionally disease was 
      limited to the lymph nodes only (10%). Severe immunosuppression (70%), anemia 
      (29%), and thrombocytopenia (17%) were common laboratory findings. Highly active 
      antiretroviral therapy (HAART) was administered to 94% of children, including 77% 
      who received HAART plus chemotherapy. KS immune reconstitution inflammatory 
      syndrome (IRIS) occurred in 22%. Disease status 12 months after KS diagnosis was 
      determined for 69 children: 43% were alive and 57% had died. Severe 
      immunosuppression was independently associated with mortality in multivariate 
      analysis (OR = 4.3; 95% CI 1.3-14.6; P = 0.02). CONCLUSION: KS occurs in a 
      significant number of HIV infected children in sub-Saharan Africa. Pediatric KS 
      is distinct from KS in adults. Lymph node involvement was a common manifestation 
      of KS in children, and severe immunosuppression was associated with the highest 
      mortality risk. Though overall mortality was high in children with KS, patients 
      did achieve clinical remission in settings with limited diagnostic and 
      therapeutic resources.
CI  - Copyright (c) 2013 Wiley Periodicals, Inc.
FAU - Cox, Carrie M
AU  - Cox CM
AD  - Baylor College of Medicine International Pediatric AIDS Initiative at Texas 
      Children's Hospital, Houston, Texas 77030-2399, USA. cc3cc3@gmail.com
FAU - El-Mallawany, Nader Kim
AU  - El-Mallawany NK
FAU - Kabue, Mark
AU  - Kabue M
FAU - Kovarik, Carrie
AU  - Kovarik C
FAU - Schutze, Gordon E
AU  - Schutze GE
FAU - Kazembe, Peter N
AU  - Kazembe PN
FAU - Mehta, Parth S
AU  - Mehta PS
LA  - eng
GR  - P30 AI036211/AI/NIAID NIH HHS/United States
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
DEP - 20130311
PL  - United States
TA  - Pediatr Blood Cancer
JT  - Pediatric blood & cancer
JID - 101186624
SB  - IM
MH  - Anemia/diagnosis/drug therapy/mortality/pathology
MH  - *Antiretroviral Therapy, Highly Active
MH  - Botswana/epidemiology
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - *HIV Infections/complications/diagnosis/drug therapy/mortality/pathology
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/diagnosis/mortality/pathology
MH  - Lymph Nodes/pathology
MH  - Malawi/epidemiology
MH  - Male
MH  - Mouth Neoplasms/diagnosis/drug therapy/mortality/pathology
MH  - Retrospective Studies
MH  - *Sarcoma, Kaposi/diagnosis/drug therapy/mortality/pathology
MH  - Skin Neoplasms/diagnosis/drug therapy/mortality/pathology
MH  - Thrombocytopenia/diagnosis/drug therapy/mortality/pathology
EDAT- 2013/03/15 06:00
MHDA- 2013/08/28 06:00
CRDT- 2013/03/15 06:00
PHST- 2012/07/02 00:00 [received]
PHST- 2013/02/04 00:00 [accepted]
PHST- 2013/03/15 06:00 [entrez]
PHST- 2013/03/15 06:00 [pubmed]
PHST- 2013/08/28 06:00 [medline]
AID - 10.1002/pbc.24516 [doi]
PST - ppublish
SO  - Pediatr Blood Cancer. 2013 Aug;60(8):1274-80. doi: 10.1002/pbc.24516. Epub 2013 
      Mar 11.