Biology and therapy of epidemic Kaposi's sarcoma.

Kaposi's sarcoma, once a rarely seen neoplasm in the West, now occurs in an epidemic fashion in association with acquired immune deficiency syndrome (AIDS). The pathogenesis of Kaposi's sarcoma is still unclear but it appears to be an endothelial neoplasm. Its clinical presentation may be quite subtle and varied. The natural history of Kaposi's sarcoma is still not fully defined, and its rate of progression may be either relatively indolent or aggressive. Therapies include local radiation, recombinant interferon alfa-2a, and cytotoxic chemotherapy. For a subset of patients with Kaposi's sarcoma who were treated with recombinant interferon alfa-2a, the disease is in complete remission, without opportunistic infection, and they appear to be culture-negative for the etiologic retrovirus that causes their immune deficiency. Interferon alfa-2a appears to have antineoplastic efficacy, (and may have antiretroviral efficacy as well) in this epidemic neoplasm.