CLASSIC KAPOSIS-SARCOMA - LOW-DOSE INTERFERON-ALPHA TREATMENT

Background: Classic Kaposi's sarcoma, a rare form of cancer, has no de finitive cure. A beneficial effect of low-dose interferon (IFN) alfa w as indicated by some case reports. In the present report, we summarize the results of our experience with subcutaneous low-dose IFN alfa tre atment of 11 patients with extensive classic Kaposi's sarcoma and revi ew the literature. Design: Eleven patients, 56-96 years old, were trea ted: 10 men, 1 woman, 3 of whom had an associated malignancy. Subcutan eous injections of IFN alfa were given, starting with 3 million units 5 times a week, and modified according to side effects and response af ter 2 weeks (2-6 million units, 3-6 times a week). This treatment was continued for 6 months, except for 1 patient who died after 4 months a nd another who stopped treatment at 4 months due to surgery but was tr eated again after recurrence. Treatment was continued after 6 months w hen a partial response was noted, but further improvement was desired (1 patient). Results: In 9 out of the 11 patients, initial response wa s noted after 3-13 weeks of treatment. This was manifested by a reduct ion of lesion size and fading of color, leading to a partial resolutio n. Maximum response was achieved after 4-6 months. Remission lasted 4- 72 months. Recurrences were retreated, with additional remissions afte r only 5-8 weeks of treatment. Side effects included fever and fatigue , which were overcome by dose reduction. Conclusion: Whereas in AIDS-r elated Kaposi's sarcoma patients become refractory to IFN, this was no t observed in our patients with classic Kaposi's sarcoma. Moreover, un like ADDS-related Kaposi's sarcoma, continuous treatment was not neede d in classic Kaposi's sarcoma, and recurrences were responsive to retr eatment.