CLASSICAL KAPOSIS-SARCOMA IN CAUCASIANS IN AFRICA EXPERIENCE AT THE JOHANNESBURG HOSPITAL (1978-1992)

The data are scant concerning classical Kaposi's sarcoma (CKS) among t he Caucasian population of Africa. A description of the clinical featu res of 15 such patients, treated and followed up at the Johannesburg G eneral Hospital over a 14-year period (1978-1992) is presented. All pa tients were negative for the human immunodeficiency virus. After a mea n follow-up of 50 months (range: 7-168 months), 2 patients are alive w ith absent or minimal disease; 1 patient is alive with stable disease and 1 has active disease involving his extremities. Three patients wer e lost to follow-up but had minimal or no disease when last seen. Five patients died of unrelated causes but also had minimal or no disease at their last visit. One patient died of sepsis related to active KS. Only two patients died of progressive KS. No alterations in humoral or cellular immunity were demonstrated in 2 patients with persistent dis ease. Four (27%) patients developed lymphoproliferative disorders incl uding non-Hodgkin's lymphoma, Waldenstrom's macroglobulinemia, Hodgkin 's disease and Castleman's disease (angiofollicular lymph node hyperpl asia) preceding or following the diagnosis of CKS. These data confirm the indolent nature and good outcome of the classical form of Kaposi's sarcoma among Caucasians in the southern African region. The marked a ssociation between CKS and lymphoproliferative disorders warrants a lo ng-term awareness and continued monitoring for these complications.