Oral Kaposi sarcoma following cord blood transplantation

[摘要] A 50-year-old man developed acute myeloid leukemia while receivingantiretroviral therapy for human immunodeficiency virus (HIV) infection. Following three courses of chemotherapy, he received cord bloodtransplantation (CBT) in the first complete remission. The patientdeveloped mild skin acute graft-versus-host disease after CBT. In addition, he developed organizing pneumonia 1 month after CBT, whichresponded to steroid therapy, but repeatedly relapsed during steroidtapering. Thus, he had been receiving prolonged immunosuppressivetherapy. Thirteen months after CBT, bluish-red elevated lesions developed on the hard palate of the oral cavity (Figure 1A). Biopsy samplesobtained from the palate lesions confirmed the diagnosis of Kaposisarcoma (KS). His HIV viral load was undetectable, and there were nosigns of leukemia relapse. To improve the immunosuppression status,immunosuppressive therapy was attenuated. This led to the increasein CD4+ count from 0.26 × 109/L to 0.68 × 109/L and regression of theKS (Figure 1B, 18 months after CBT). However, the patient succumbedto heart and kidney failure 18 months after CBT. Despite its rarity, KSshould be considered as a differential diagnosis when hematopoieticstem cell transplantation recipients develop bluish-red or purplelesions.

[关键词] cord blood transplantation;immunodeficiency;Kaposi sarcoma