Dear Dr Virginia

as you know there are four standard treatment plan for capos sarcoma, radiotherapy,surgery, chemotherapy and biologic

i suggest to read this paper:

Kaposi Sarcoma Treatment (PDQ®): Patient Version.

Authors

PDQ Adult Treatment Editorial Board.

SourcePDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-.

2016 Mar 21.

Excerpt

This PDQ cancer information summary has current information about the treatment of Kaposi sarcoma. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care. Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board.

KEYWORDS:

Kaposi sarcoma

best wishes

HI Virginia

We see a lot of HIV associated Kaposi sarcoma in South Africa. We have not yet had to resort to radiation therapy. In our unit we use monthly DBV - doxorubicin, bleomycin, vinblastine. If you would like more details, you are welcome to email me on [email protected]

I don't have any experience of using chemotherapy in ataxia-telangiectasia, however. 

Good luck. 

Jennifer 

The patient is immunosuppressed by corticosteroid therapy due to concomitant autoimmune disease. It is not HIV-positive. He can't suspend corticosteroid therapy.

Dear Dr Virginia, Antiretroviral treatment of HIV began in the mid-1980s with the nucleoside analogue zidovudine (azidothymidine) and the demonstration that this was better than placebo in the treatment of symptomatic disease. However, the treatment of HIV infection was revolutionized in developed countries as a result of the introduction of HAART. This has reduced short-term mortality and markedly increased quality of life by preventing opportunistic diseases. HAART has developed as a result of controlled trials showing that dual nucleoside analogue therapy improves survival compared with zidovudine monotherapy [27], and that three-drug therapy consisting

of two nucleoside analogues and a protease inhibitor is superior to two drugs.

In case of Kaposi,s sarcoma the following modalities of treatments were suggested by Bunker & Staughton; Bower & Portsmouth:

Local treatment

Cryotherapy

Radiotherapy

Topical retinoids: alitretinoin.

Topical antivirals: cidofovir, docosanol.

Intralesional, e.g. TNF-a, IFN-a, vinca alkaloids.

Surgery, e.g. curettage, cautery, infrared coagulation.

Laser.

Photodynamic therapy.

Cosmetic camouflage.

Systemic treatment

Highly active antiretroviral therapy (HAART)

Isotretinoin (cidofovir)

Aggressive chemotherapy, e.g. daunorubicin, doxorubicin,

bleomycin, paclitaxel, vincristine, etoposide

Human chorionic gonadotrophin.

Interleukin-4.

Dear Dr Virginia, is your patient a child? if so you know that Ataxia-telangiectasia considered as one of the differential diagnosis of childhood immunosuppression.

DiGeorge’s syndrome

Ataxia-telangiectasia

Wiskott–Aldrich syndrome

Agammaglobulinaemias

T-cell and B-cell immunodeficiencies

Malnutrition

Malignancy

Congenital infections

Iatrogenic immunosuppression

Graft-versus-host disease

He is 41 years old, and he has ataxia telangiectasia and idiopathic thrombocytopenic purpura, under corticosteroid therapy.