HAND-FOOT SYNDROME-ASSOCIATED WITH LIPOSOME-ENCAPSULATED DOXORUBICIN THERAPY

Background. Acquired immune deficiency syndrome (AIDS)-related Kaposi' s sarcoma (KS) is a common complication of patients infected with huma n immunodeficiency virus and can cause significant morbidity. Long ter m therapy with standard chemotherapeutic regimens has been limited by relatively short durations of response and potential toxicity. Once th erapy is discontinued, the disease typically progresses. Liposome-enca psulated doxorubicin (DOX-SL) currently is being evaluated for treatin g patients with AIDS-related KS. Early reports suggest a high response rate and good patient tolerance permitting continued therapy for exte nded periods. Methods. Patients with AIDS-related KS are treated with a DOX-SL regimen every 2-3 weeks and are followed carefully for eviden ce of adverse treatment effects. Results. Two cases of hand-foot syndr ome (HFS) in patients receiving DOX-SL for AIDS-related KS are reporte d. Tissue studies demonstrated changes consistent with a toxic effect of the drug on keratinocytes. Hand-foot syndrome was reversible once t reatment stopped; however, treatment cessation resulted in primary dis ease recurrence. Conclusions. Hand-foot syndrome can be debilitating a nd may be a limiting factor in the prolonged use of DOX-SL for AIDS-re lated KS for some patients. It is critical for clinicians using this d rug to identify this side effect to limit HFS-associated morbidity.