Pediatric Hematology/Oncology and ImmunopathologyPediatric Hematology/Oncology and ImmunopathologyВопросы гематологии/онкологии и иммунопатологии в педиатрии1726-17082414-9314Fund Doctors, Innovations, Science for Children102110.24287/1726-1708-2025-24-2-116-122RXCTIKCLINICAL OBSERVATIONSКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯResearch ArticleDisseminated Kaposi's sarcoma in a child treated with allogeneic hematopoietic stem cell transplantationДиссеминированная саркома Капоши у ребенка после аллогенной трансплантации гемопоэтических стволовых клетокhttps://orcid.org/0009-0004-4814-297XLemeshevMikhail A.ЛемешевМихаил Алексеевич
Russian Federation
mikhail.lemeshev@dgoi.ruhttps://orcid.org/0000-0003-3949-248XVasilievaAnna P.ВасильеваАнна Петровна
Russian Federation
no-reply@eco-vector.ruhttps://orcid.org/0000-0002-7696-1153RadyginaSvetlana A.РадыгинаСветлана Анатольевна
Russian Federation
ra-svet-7@yandex.ruhttps://orcid.org/0000-0003-3664-2876AbramovDmitry S.АбрамовДмитрий Сергеевич
Russian Federation
dmitry.abramov@fccho-moscow.ruhttps://orcid.org/0000-0001-7265-0414KhachatryanLili A.ХачатрянЛили Альбертовна
Russian Federation
Lili.Hachatryan@dgoi.ruhttps://orcid.org/0000-0002-6314-2132AbashidzeZalina A.АбашидзеЗалина Ахмедовна
Russian Federation
zalina.abashidze@dgoi.ruhttps://orcid.org/0000-0002-1754-1220KozlovskayaSvetlana N.КозловскаяСветлана Николаевна
Russian Federation
lana.n.kozlovskaya@gmail.comhttps://orcid.org/0000-0002-0566-053XSkvortsovaYulia V.СкворцоваЮлия Валериевна
Russian Federation

MD, Dr. Sci. (Medicine)

д-р мед. наук

yuscvo@mail.ruhttps://orcid.org/0000-0003-2689-0569BalashovDmitry N.БалашовДмитрий Николаевич
Russian Federation
bala8@yandex.ruhttps://orcid.org/0000-0002-0016-6698MaschanAlexey A.МасчанАлексей Александрович
Russian Federation
Aleksey.Maschan@dgoi.ruDmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and ImmunologyФГБУ «Национальный медицинский исследовательский центр детской гематологии, онкологии и иммунологии им. Дмитрия Рогачева» Минздрава России08092025300620252421161220809202508092025Copyright ©; 2025, «D. Rogachev NMRCPHOI»Copyright ©; 2025, ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава России2025«D. Rogachev NMRCPHOI»ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава Россииhttps://creativecommons.org/licenses/by/4.0https://hemoncim.com/jour/article/view/1021

Kaposi's sarcoma (KS) is a rare complication of hematopoietic stem cell transplantation (HSCT). Here, we report a case of disseminated KS in a pediatric patient after haploidentical HSCT that developed during secondary immunosuppression. Treatment with liposomal doxorubicin resulted in a complete metabolic response. This case highlights the importance of early diagnosis and stresses the need to consider KS in the differential diagnosis of cutaneous and systemic manifestations in patients following HSCT. The patient's parents gave consent to the use of their child's data, including photographs, for research purposes and in publications.

Саркома Капоши (СК) - редкое осложнение после трансплантации гемопоэтических стволовых клеток (ТГСК). В работе описан случай диссеминированной СК у ребенка после гаплоидентичной ТГСК, развившейся на фоне вторичной иммуносупрессии. Лечение липосомальным доксорубицином привело к полному метаболическому ответу. Этот случай подчеркивает важность ранней диагностики и включения СК в дифференциальный ряд кожных и системных проявлений у пациентов после ТГСК. Родители пациента дали согласие на использование информации, в том числе фотографий ребенка, в научных исследованиях и публикациях.

Kaposi's sarcomaHHV-8hematopoietic stem cell transplantationliposomal doxorubicinimmunosuppressionpediatricsсаркома КапошиHHV-8трансплантация гемопоэтических стволовых клетоклипосомальный доксорубициниммуносупрессияпедиатрияMesri E.A., Cesarman E., Boshoff C. Kaposi's sarcoma and its associated herpesvirus. Nat Rev Cancer 2010; 10 (10): 707-19. DOI: 10.1038/ nrc2888Chang Y., Cesarman E., Pessin M.S., Lee F., Culpepper J., Knowles D.M., Moore P.S. Identification of herpesvirus-like DNA sequences in AIDS-associated Kaposi's sarcoma. Science 1994; 266 (5192): 1865-9. DOI: 10.1126/science.7997879WHO Classification of Tumours of Soft Tissue and Bone, Vol. 3. 5th ed. IARC; 2020.Mikulska M., Balletto E., Mularoni A. Human herpesvirus 8 and Kaposi sarcoma: how should we screen and manage the transplant recipient? Curr Opin Infect Dis 2021; 34 (6): 646-53. DOI: 10.1097/QCO.000000000000079208.05.2025.Острый лимфобластный лейкоз. Клинические рекомендации Минздрава России. 2023 [Электронный ресурс] URL: https://cr.minzdrav.gov.ru/view-cr/529_2, свободный (дата обращения 08.05.2025.)Вавилова Л.А., Дьяконова Ю.Ю., Быданов О.И., Мякова Н.В., Абугова Ю.Г., Андержанова Л.Х. и др. Роль блинатумомаба в лечении В-клеточных рецидивов острого лимфобластного лейкоза у детей: собственный опыт применения. Вопросы гематологии/онкологии и иммунопатологии в педиатрии 2023; 22 (1): 62-72. DOI: 10.24287/1726-1708-2023-22-1-62-72Polizzotto M.N., Uldrick T.S., Wyvill K.M., Aleman K., Marshall V., Wang V., et al. Clinical features and outcomes of patients with symptomatic kaposi sarcoma herpesvirus (KSHV)-associated Inflammation: prospective characterization of KSHV inflammatory cytokine syndrome (KICS). Clin Infect Dis 2016; 62 (6): 730-8. DOI: 10.1093/cid/ civ996. Erratum in: Clin Infect Dis 2018; 66 (6): 985. DOI: 10.1093/cid/ cix831Parravicini C., Chandran B., Corbellino M., Berti E., Paulli M., Moore P.S., Chang Y. Differential viral protein expression in Kaposi's sarcoma-associated herpesvirus-infected diseases: Kaposi's sarcoma, primary effusion lymphoma, and multicentric Castleman's disease. Am J Pathol 2000; 156 (3): 743-9. DOI: 10.1016/S0002-9440(10)64940-1Mariggio G., Koch S., Schulz T.F. Kaposi sarcoma herpesvirus pathogenesis. Philos Trans R Soc Lond B Biol Sci 2017; 372 (1732): 20160275. DOI: 10.1098/rstb.2016. 0275Kaaya E.E., Parravicini C., Sundelin B., Mgaya E., Kitinya J., Lema L., et al. Spindle cell ploidy and proliferation in endemic and epidemic African Kaposi's sarcoma. Eur J Cancer 1992; 28A (11): 1890-4. DOI: 10.1016/0959-8049(92) 90030-6Hodak E., Hammel I., Feinmesser M., Zelinger A., Maron L., Sulkes J., David M. Differential expression of p53 and Ki-67 proteins in classic and iatrogenic Kaposi's sarcoma. Am J Dermatopathol 1999; 21 (2): 138-45. DOI: 10.1097/00000372-19990400000005Stallone G., Schena A., Infante B., Di Paolo S., Loverre A., Maggio G., et al. Sirolimus for Kaposi's sarcoma in renal-transplant recipients. N Engl J Med 2005; 352 (13): 1317-23. DOI: 10.1056/NEJMoa042831(7)Roy D., Sin S.H., Lucas A., Venkataramanan R., Wang L., Eason A., et al. mTOR inhibitors block Kaposi sarcoma growth by inhibiting essential autocrine growth factors and tumor angiogenesis. Cancer Res 2013; 73(7): 2235-46. DOI: 10.1158/0008-5472.CAN-12-1851Deauna-Limayo D., Rajabi B., Qiu W., Htut M., Sweetenham J. Kaposi sarcoma after non-myeloablative hematopoietic stem cell transplant: response to withdrawal of immunosuppressant therapy correlated with whole blood human herpesvirus-8 reverse transcriptase-polymerase chain reaction levels. Leuk Lymphoma 2013; 54 (10): 2299-302. DOI: 10.3109/10428194.2013.769221Cheng F., Pekkonen P., Laurinavicius S., Sugiyama N., Henderson S., Gunther T., et al. KSHV-initiated notch activation leads to membrane-type-1 matrix metalloproteinase-dependent lymphatic endothelial-to-mesenchymal transition. Cell Host Microbe 2011; 10 (6): 577-90. DOI: 10.1016/j. chom.2011.10.011Gasperini P., Espigol-Frigole G., McCormick P.J., Salvucci O., Maric D., Uldrick T.S., et al. Kaposi sarcoma herpesvirus promotes endothelial-to-mesenchymal transition through Notch-dependent signaling. Cancer Res 2012; 72 (5): 1157-69. DOI: 10.1158/0008-5472. CAN-11-3067Morris V.A., Punjabi A.S., Wells R.C., Wittkopp C.J., Vart R., Lagunoff M. The KSHV viral IL-6 homolog is sufficient to induce blood to lymphatic endothelial cell differentiation. Virology 2012; 428 (2): 112-20. DOI: 10.1016/j.virol.2012.03.013Bala K., Bosco R., Gramolelli S., Haas D.A., Kati S., Pietrek M., et al. Kaposi's sarcoma herpesvirus K15 protein contributes to virus-induced angiogenesis by recruiting PLCg1 and activating NFAT1-dependent RCAN1 expression. PLoS Pathog 2012;8 (9): e1002927. DOI: 10.1371/ journal.ppat.1002927Gramolelli S., Weidner-Glunde M., Abere B., Viejo-Borbolla A., Bala K., Ruckert J., et al. Inhibiting the recruitment of PLCg1 to Kaposi's sarcoma herpesvirus K15 protein reduces the invasiveness and angiogenesis of infected endothelial cells. PLoS Pathog 2015; 11 (8): e1005105. DOI: 10.1371/journal. ppat.1005105He M., Zhang W., Bakken T., Schutten M., Toth Z., Jung J.U., et al. Cancer angiogenesis induced by Kaposi sarcoma-associated herpesvirus is mediated by EZH2. Cancer Res 2012; 72 (14): 3582-92. DOI: 10.1158/0008-5472.CAN-11-2876. Erratum in: Cancer Res 2013; 73(17): 5603-5.Brambilla L., Aromolo I.F., Buffon S., Benaglia C., Tourlaki A. Koebner phenomenon in Kaposi's sarcoma: a large single-center case series and review of current knowledge. J Cutan Med Surg 2023; 27 (2): 102-7. DOI: 10.1177/12034754221149658Grayson W., Pantanowitz L. Histological variants of cutaneous Kaposi sarcoma. Diagn Pathol 2008; 3: 31. DOI: 10.1186/1746-1596-3-31Haas D.A., Bala K., Busche G., Weidner-Glunde M., Santag S., Kati S., et al. The inflammatory kinase MAP4K4 promotes reactivation of Kaposi's sarcoma herpesvirus and enhances the invasiveness of infected endothelial cells. PLoS Pathog 2013; 9 (11): e1003737. DOI: 10.1371/journal.ppat. 1003737Leidner R.S., Aboulafia D.M. Recrudescent Kaposi's sarcoma after initiation of HAART: a manifestation of immune reconstitution syndrome. AIDS Patient Care STDS 2005; 19 (10): 635-44. DOI: 10.1089/ apc.2005.19.635Cesaro S., Tridello G., van der Werf S., Bader P., Socie G., Ljungman P., et al. Incidence and outcome of Kaposi sarcoma after hematopoietic stem cell transplantation: a retrospective analysis and a review of the literature, on behalf of infectious diseases working party of EBMT. Bone Marrow Transplant 2020; 55 (1): 110-6. DOI: 10.1038/ s41409-019-0644-8NCCN Clinical Practice Guidelines in Oncology. Kaposi sarcoma Version 1.2024, November, 2023.Lebbe C., Garbe C., Stratigos A.J., Harwood C., Peris K., Marmol V.D., et al.; European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO) and the European Organisation for Research and Treatment of Cancer (EORTC). Diagnosis and treatment of Kaposi's sarcoma: European consensus-based interdisciplinary guideline (EDF/EADO/EORTC). Eur J Cancer 2019; 114: 117-27. DOI: 10.1016/j. ejca.2018.12.036Swain S.M., Whaley F.S., Ewer M.S. Congestive heart failure in patients treated with doxorubicin: a retrospective analysis of three trials. Cancer 2003; 97 (11): 2869-79. DOI: 10.1002/cncr.11407Yokota K., Yotsumoto M., Muramatsu T., Saito M., Kamikubo Y., Ichiki A., et al. Long-term administration of pegylated liposomal doxorubicin at almost twice the recom¬mended lifetime dose in 10 years, without cardiotoxicity in a Japanese patient with HIV-associated Kaposi sarcoma. J Infect Chemother 2020; 26 (2): 289-91. DOI: 10.1016/j.jiac.2019.08.016