Hemoglobin and C-reactive protein levels as predictive factors for long-term successful glucocorticoid treatment for multicentric Castleman’s disease

Ebisawa, Kazutoshi; Shimura, Arika; Honda, Akira; Masamoto, Yosuke; Nakahara, Fumio; Kurokawa, Mineo

doi:10.1080/10428194.2020.1834094

Cited by 8 publications

(3 citation statements)

References 17 publications

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“…Given the fact that the pathophysiology of sepsis, characterized by cytokine release, systemic inflammation, lymphopenia, and following immunosuppression, is similar to that of COVID-19 to a certain extent [ 41 , 42 ], we have reason to believe the reliability of two selected features in our model. Additionally, Ebisawa et al uncovered that lower CRP predicted stronger corticosteroid responsiveness in multicentric Castleman’s disease with unknown mechanisms [ 43 ]. Considering the immunomodulatory and anti-inflammatory functions of corticosteroid [ 44 ], the effects of corticosteroid may depend on the function of immune system.…”

Section: Discussionmentioning

confidence: 99%

PRCTC: a machine learning model for prediction of response to corticosteroid therapy in COVID-19 patients

Gao

Xiong

Jiao

et al. 2022

Aging

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Corticosteroid has been proved to be one of the few effective treatments for COVID-19 patients. However, not all the patients were suitable for corticosteroid therapy. In this study, we aimed to propose a machine learning model to forecast the response to corticosteroid therapy in COVID-19 patients. We retrospectively collected the clinical data about 666 COVID-19 patients receiving corticosteroid therapy between January 27, 2020, and March 30, 2020, from two hospitals in China. The response to corticosteroid therapy was evaluated by hospitalization time, oxygen supply duration, and the outcomes of patients. Least Absolute Shrinkage and Selection Operator (LASSO) was applied for feature selection. Five prediction models were applied in the training cohort and assessed in an internal and an external validation dataset, respectively. Finally, two (C reactive protein, lymphocyte percent) of 36 candidate immune/inflammatory features were finally used for model development. All five models displayed promising predictive performance. Notably, the ensemble model, PRCTC (prediction of response to corticosteroid therapy in COVID-19 patients), derived from three prediction models including Gradient Boosted Decision Tree (GBDT), Neural Network (NN), and logistic regression (LR), achieved the best performance with an area under the curve (AUC) of 0.810 (95% confidence interval [CI] 0.760–0.861) in internal validation cohort and 0.845 (95% CI 0.779–0.911) in external validation cohort to predict patients’ response to corticosteroid therapy. In conclusion, PRCTC proposed with universality and scalability is hopeful to provide tangible and prompt clinical decision support in management of COVID-19 patients and potentially extends to other medication predictions.

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Section: Discussionmentioning

confidence: 99%

PRCTC: a machine learning model for prediction of response to corticosteroid therapy in COVID-19 patients

Gao

Xiong

Jiao

et al. 2022

Aging

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“…Glucocorticoids have been used to treat CD before the appearance of siltuximab and can improve the symptoms of acute exacerbation of iMCD[ 13 ]; however, the response level is low. The failure rate of glucocorticoids alone in the treatment of CD is as high as 50%[ 14 ]. At present, siltuximab is not listed in China and the patient's IL-6 Level is low, so its use is considered as an alternative treatment.…”

Section: Discussionmentioning

confidence: 99%

Glucocorticoids combined with tofacitinib in the treatment of Castleman's disease: A case report

Liu¹,

Tian²

2022

World J Clin Cases

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BACKGROUND Castleman's disease (CD), also known as vascular follicular lymphadenopathy is a rare proliferative disease of lymphoid tissue of unknown etiology that is clinically classified as unicentric CD (UCD) or multicentric CD (MCD) depending on lymph node involvement. At present, idiopathic MCD (iMCD) is treated with interleukin-6 inhibitors, but some patients have poor clinical outcomes. This paper reports on a case of iMCD that achieved a good therapeutic effect after treatment with glucocorticoids combined with tofacitinib. The relevant data are summarized and reported below. CASE SUMMARY This paper reports on a case of MCD in a 49-year-old female with persistent peritoneal effusion as the first manifestation and combined with multiple lymphadenopathies. Lymph node biopsy showed Castleman's disease-like changes. The ascites subsided after treatment with glucocorticoids and tofacitinib, indicating that the treatment was effective. CONCLUSION The combination of glucocorticoids with tofacitinib is an effective regimen for the treatment of CD.

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“…Severe iMCD can be assumed when at least two of 5 factors are present: an ECOG score ≥2, signs of organ dysfunction such as renal failure (GFR < 30), anasarca and/or ascites, severe anemia (Hb of <8 mg/dL), and pulmonary involvement or interstitial pneumonia [5]. Steroid monotherapy is only appropriate in mild cases with low CRP [61].…”

Section: Idiopathic MCDmentioning

confidence: 99%

Recent Advances in Castleman Disease

et al. 2022

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Background: Castleman disease (CD) encompasses a spectrum of rare disorders with characteristic histopathological features. Unicentric Castleman disease (UCD) is a benign, local hyperplasia of lymphoid tissue that is usually curable. Multicentric Castleman disease (MCD) manifests as a potentially life-threatening systemic disease with complex symptomatology which is mostly due to an overproduction of interleukin-6 (IL-6) or dysregulation of IL-6-related signaling pathways. From a therapeutic perspective, it is important to distinguish idiopathic MCD (iMCD) from those cases that are associated with the human herpes virus 8 (HHV-8+MCD). Summary: During recent years, it has become increasingly clear that even HHV-8-negative MCD is not a homogeneous entity and that there are clinically distinct variants. International consensus guidelines for diagnosis and treatment have been developed for iMCD and UCD. Key messages: We herein summarize recent advances in diagnosis, treatment and novel insights into the pathogenesis of this disease.

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Hemoglobin and C-reactive protein levels as predictive factors for long-term successful glucocorticoid treatment for multicentric Castleman’s disease

Cited by 8 publications

References 17 publications

PRCTC: a machine learning model for prediction of response to corticosteroid therapy in COVID-19 patients

PRCTC: a machine learning model for prediction of response to corticosteroid therapy in COVID-19 patients

Glucocorticoids combined with tofacitinib in the treatment of Castleman's disease: A case report

Recent Advances in Castleman Disease

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