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- Title
Histological evidence for the cardiac safety of high-dose pegylated liposomal doxorubicin in a patient with HIV-associated Kaposi sarcoma: a case report and literature review.
- Authors
Ishihara, Ayaka; Hatakeyama, Shuji; Suzuki, Jun; Amano, Yusuke; Sasahara, Teppei; Toshima, Masaki; Morisawa, Yuji
- Abstract
<bold>Background: </bold>Pegylated liposomal doxorubicin plays an important role in the treatment of patients with severe refractory human immunodeficiency virus (HIV)-associated Kaposi sarcoma (KS). High cumulative doses of conventional doxorubicin exceeding 500 mg/m2 are known to cause cardiac toxicity. However, the safe cumulative dose of pegylated liposomal doxorubicin is unclear.<bold>Case Presentation: </bold>A 40-year-old Japanese man with HIV infection presented with pain, edema, and multiple skin nodules on both legs which worsened over several months. He was diagnosed with HIV-associated KS. He received long-term pegylated liposomal doxorubicin combined with antiretroviral therapy for advanced, progressive KS. The cumulative dose of pegylated liposomal doxorubicin reached 980 mg/m2. The patient's left ventricular ejection fraction remained unchanged from baseline during treatment. After he died as a result of cachexia and wasting, caused by recurrent sepsis and advanced KS, an autopsy specimen of his heart revealed little or no evidence of histological cardiac damage. We also conducted a literature review focusing on histological changes of the myocardium in patients treated with a cumulative dose of pegylated liposomal doxorubicin exceeding 500 mg/m2.<bold>Conclusions: </bold>This case report and literature review suggest that high (> 500 mg/m2) cumulative doses of pegylated liposomal doxorubicin may be used without significant histological/clinical cardiac toxicity in patients with HIV-associated KS.
- Subjects
KAPOSI'S sarcoma; DOXORUBICIN; LITERATURE reviews; HIV infections; VENTRICULAR ejection fraction
- Publication
BMC Infectious Diseases, 2019, Vol 19, Issue 1, pN.PAG
- ISSN
1471-2334
- Publication type
journal article
- DOI
10.1186/s12879-019-4500-7