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Alexander J. Stratigos, MD; Dimitrios Malanos, MD; Giota Touloumi, PhD; Anna Antoniou, MSc; Irene Potouridou, MD; Dorothea Polydorou, MD; Andreas D. Katsambas, MD; Denise Whitby, PhD; Nancy Mueller, ScD; John D. Stratigos, MD; Angelos Hatzakis, MD

Arch Dermatol. 2005;141:1421-1426.

Objective  To evaluate various immunologic markers in the peripheral blood of patients with early and advanced classic Kaposi’s sarcoma (CKS).

Design  Cross-sectional study.

Setting  A major referral center for skin and venereal diseases.

Patients  Sixty-eight patients with histologically confirmed CKS staged according to a modified version of the Mitsuyasu-Groopman classification in stage I-II (cutaneous involvement only) and stage IV (skin and systemic involvement).

Main Outcome Measures  Concentrations of neopterin and ₂-microglobulin, titer of anti–human herpesvirus 8 antibodies, number of natural killer cells, and numbers of total lymphocytes, B lymphocytes, T lymphocytes, and their subsets in peripheral blood.

Results  The median values of ₂-microglobulin and neopterin were elevated in patients with CKS in stage IV (median, 3.679 µg/mL [312.72 nmol/L] and 14.0 nmol/L, respectively) compared with patients in stage I-II (median, 2.406 µg/mL [204.51 nmol/L] and 6.5 nmol/L, respectively). A statistically significant reduction in total lymphocyte and B-lymphocyte counts was observed in patients with advanced-stage CKS (1679/µL and 79/µL, respectively) compared with patients in earlier stages of the disease (2142/µL and 224/µL, respectively). The human herpesvirus 8 antibody titer, determined by latent immunofluorescent assay, decreased from stage I-II to stage IV, although not at a statistically significant level (P = .14).

Conclusion  The evolution of CKS from the early stages of the disease to the more advanced may be associated with a partial activation of the immune system and a gradual decrease in the number of total and B lymphocytes.

Author Affiliations: Department of Dermatology, University of Athens, Andreas Sygros Hospital, Athens, Greece (Drs A. J. Stratigos, Malanos, Potouridou, Polydorou, Katsambas, and J. D. Stratigos); National Retroviral Center, Department of Hygiene and Epidemiology, University of Athens (Drs Touloumi and Hatzakis and Ms Antoniou); Viral Epidemiology Section, AIDS Vaccine Program, National Cancer Institute, Bethesda, Md (Dr Whitby); and Department of Epidemiology, Harvard School of Public Health, Boston, Mass (Dr Mueller).

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