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Case Reports
. 2023 Jun 1;16(6):e251044.
doi: 10.1136/bcr-2022-251044.

Iatrogenic Kaposi's sarcoma from induction therapy for myeloma: to transplant or not to transplant?

Daniel Farrugia  1 , Erika Sultana  2 , Darko Babic  3 , Mark Grech  2
Affiliations
Case Reports

Iatrogenic Kaposi's sarcoma from induction therapy for myeloma: to transplant or not to transplant?

Daniel Farrugia et al. BMJ Case Rep. .

Abstract

We present the case of an HIV-negative man in his 50s who developed a generalised nodular rash while having first-line bortezomib-cyclophosphamide-dexamethasone chemotherapy for multiple myeloma. The rash was biopsied and proven to be Kaposi's sarcoma. The patient's treatment was interrupted at the sixth cycle of chemotherapy, by which time the rash had also spread to the oral mucosa and eyelid. The rash regressed spontaneously on stopping treatment. We were reluctant to restart myeloma treatment, but on the other hand, we wished to consolidate the very good partial response achieved. An autologous marrow transplant was done months later without any recurrence of his Kaposi's with the initiation of bortezomib maintenance. Bortezomib has putative activity against Kaposi's. The patient could benefit from imid-based (thalidomide, lenalidomide, pomalidomide) combination chemotherapy once his myeloma progresses or if there is a recurrence of Kaposi's sarcoma.

Keywords: haematology (incl blood transfusion); malignant disease and immunosuppression; oncology.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Composite picture showing skin nodule with Kaposi’s sarcoma H&E (A) and human herpesvirus-8 staining (B). Note the typical nodular dermal spindle shaped cells proliferation and vascular spaces on H&E staining and positive nuclear staining for human herpesvirus-8 antibody (×100 magnification).
Figure 2
Figure 2
Composite picture showing Kaposi’s lesions before interruption of treatment: panels on the left showing: (A) lesion in right upper gum mucosa, (C) lesion at right ocular caruncle, (E) lesions on left side of neck. Resolution of skin tumours after treatment interruption (B, D, F).
See this image and copyright information in PMC

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