HTB

Prognostic index for risk of progression of Kaposi’s Sarcoma

9 September 2006. Related: Conference reports, Coinfections and complications, .

Simon Collins, HIV i-Base

Mark Bower and colleagues from the Chelsea and Westminster Hospital London, presented a prognostic score for patients diagnosed with Kaposi’s Sarcoma (KS), derived from analysing covariates predictive of overall survival in a cohort of 326 HIV+ patients who developed KS since 1996.

The score in these patients, ranged from 0 to 15 and was calculated starting at the number 10. It incorporated:

  • S stage – other ADI: +3 (any other HIV-related illness)
  • age: +2 (if >50 years old at diagnosis)
  • KS as first ADI: -2 (if KS is the ADI), and
  • CD4 cell count: -1 (per 100 cells/mm3 at diagnosis)

Individuals with a prognostic score of 0, 5, 10 and 15, had 1 year survivals of 99.4%, 96.7%, 83.4% and 37.8% and 5 year survivals of 98.4%, 91.8%, 63.1% and 8.4% respectively. Increasing the prognostic score by 1 increased the risk of death by 40% (HR 1.4, 95% CI 1.28-1.53, bootstrapped HR 1.39, 95% CI 1.25-1.51) and the index has a concordance of 76.8% (95% CI 71.7-82.3%). The prognostic index, validated internally using a bootstrap procedure with resampled data, applied to individuals on and off HAART at KS diagnosis.

The study concluded that this score can be used to guide therapeutic options.

Reference:

Bower M, Sanitt A, Mazhar D et al. A prognostic index for AIDS-associated Kaposi Sarcoma in the era of highly active antiretroviral therapy. Poster abstract TUPE0046.

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