Remissions of different quality following rituximab, tocilizumab and rituximab, and allogeneic stem cell transplantation in a patient with severe idiopathic multicentric Castleman’s disease

Angenendt, Linus; Kerkhoff, Andrea; Wiebe, Stephanie A.; Mikesch, Jan‐Henrik; Rudat, Annika; Wötzel, Fabian; Wenning, Christian; Schliemann, Christoph; Keßler, Torsten; Schäfers, Michael; Wardelmann, Eva; Stelljes, Matthias; Berdel, Wolfgang E.

doi:10.1007/s00277-015-2353-8

Cited by 7 publications

(7 citation statements)

References 10 publications

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“…Autologous and allogeneic stem cell transplantation has only been reported in a few cases with mixed results and are therapies of last resort. [80][81][82][83] Severe iMCD often presents as the TAFRO subtype. Our analysis of 49 published iMCD-TAFRO cases with treatment data revealed that corticosteroids, anti-IL-6 mAbs, cytotoxic chemotherapies, and cyclosporine A are most often used.…”

Section: Decrease Of ≥1°c Relative To Baselinementioning

confidence: 99%

International, evidence-based consensus treatment guidelines for idiopathic multicentric Castleman disease

Rhee

Voorhees

Dispenzieri

et al. 2018

Blood

275

352

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Abstract Castleman disease (CD) describes a group of heterogeneous hematologic disorders with characteristic histopathological features. CD can present with unicentric or multicentric (MCD) regions of lymph node enlargement. Some cases of MCD are caused by human herpesvirus-8 (HHV-8), whereas others are HHV-8–negative/idiopathic (iMCD). Treatment of iMCD is challenging, and outcomes can be poor because no uniform treatment guidelines exist, few systematic studies have been conducted, and no agreed upon response criteria have been described. The purpose of this paper is to establish consensus, evidence-based treatment guidelines based on the severity of iMCD to improve outcomes. An international Working Group of 42 experts from 10 countries was convened by the Castleman Disease Collaborative Network to establish consensus guidelines for the management of iMCD based on published literature, review of treatment effectiveness for 344 cases, and expert opinion. The anti–interleukin-6 monoclonal antibody siltuximab (or tocilizumab, if siltuximab is not available) with or without corticosteroids is the preferred first-line therapy for iMCD. In the most severe cases, adjuvant combination chemotherapy is recommended. Additional agents are recommended, tailored by disease severity, as second- and third-line therapies for treatment failures. Response criteria were formulated to facilitate the evaluation of treatment failure or success. These guidelines should help treating physicians to stratify patients based on disease severity in order to select the best available therapeutic option. An international registry for patients with CD (ACCELERATE, #NCT02817997) was established in October 2016 to collect patient outcomes to increase the evidence base for selection of therapies in the future.

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Section: Decrease Of ≥1°c Relative To Baselinementioning

confidence: 99%

International, evidence-based consensus treatment guidelines for idiopathic multicentric Castleman disease

Rhee

Voorhees

Dispenzieri

et al. 2018

Blood

275

352

View full text Add to dashboard Cite

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“…Notably, 14/18 (78%) iMCD‐TAFRO patients responded to a combination including anti‐IL‐6 therapy (siltuximab or tocilizumab) and 9/13 (69%) responded to anti‐IL‐6 therapy±corticosteroids, according to the case report authors' assessments; three patients who responded to anti‐IL‐6 ± corticosteroids relapsed before the time of publication (Table 3). 17‐29 We also assessed all of the iMCD‐TAFRO and iMCD‐NOS cases with HyperV or HV histopathology at UAMS that were treated with anti‐IL‐6 therapy±corticosteroids. Here, 4/4 iMCD‐TAFRO and 7/7 iMCD‐NOS patients responded, according to the investigator's assessment of clinical and laboratory abnormalities.…”

Section: Resultsmentioning

confidence: 99%

“…therapy (siltuximab or tocilizumab) and 9/13 (69%) responded to anti-IL-6 therapy±corticosteroids, according to the case report authors' assessments; three patients who responded to anti-IL-6 ± corticosteroids relapsed before the time of publication (Table 3). [17][18][19][20][21][22][23][24][25][26][27][28][29] We also assessed all of the iMCD-TAFRO and iMCD- Anti-IL-6 + rituximab or cyclosporine ± CS iMCD-TAFRO 5 5 3…”

Section: Real-world Datamentioning

confidence: 99%

Insufficient evidence exists to use histopathologic subtype to guide treatment of idiopathic multicentric Castleman disease

Fajgenbaum

Goodman

et al. 2020

American J Hematol

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“…To our knowledge, only one case of a patient with severe MCD who received allo-HSCT after rituximab monotherapy followed by six months of follow-up has been reported 10 . The reasons why we added the etoposide in the conditioning regimen were as follows: (1) It was reported that both Bu/Cy plus etoposide as conditioning for autologous stem cell transplantation in MM was a safe regimen 11 and treatment of HIV-associated MCD with etoposide 12 had substantial efficacy.…”

Section: Discussionmentioning

confidence: 99%

A Case of Successful Allogeneic Hematopoietic Stem Cell Transplantation for HHV8-Positive Castleman’s Disease with a Review of the Literature

et al. 2020

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Objective: To investigate the long-term clinical efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for patients with human herpes virus 8 (HHV8)-positive multicentric Castleman’s disease (MCD). Methods: A 17-year-old female patient was admitted to Henan Provincial People’s Hospital with the complaint of febrile for half a month, headache, and enlarged superficial lymph nodes on October 5, 2010. HHV8-positive mixed cellular Castleman’s disease was found by pathological diagnosis of lymph nodes biopsy. After the administration of CHOP and Hyper-CVAD-B, the patient was still febrile, we administrated the followed COAP, two courses of VAD(Vincristine, Adriamycin, Dexamethasone), the patient received CR. Six months after CR, the patient relapsed, we administrated VAD and two courses of bortezomide+dexamethasone chemotherapy, and then the patient received PR. After that, the patient underwent allo-HSCT from his human leukocyte antigen (HLA)-matched unrelated donor after conditioning with Bu/Cy+Etoposide+Smoustin.graft-vs-host disease (GVHD) prophylaxis, which consisted of ATG (7.5 mg/kg, qd, ivdrip) from d-5 to d-2, cyclosporine (3 mg/kg/d, qd, ivdrip, for 24 h) started from day-1, MMF(0.5 g, tid, po.) started from day+1 to +28, and MTX (15 mg per time, ivdrip, d+1,+4,+7,+11). She received 3.5×106/L CD34+cells and 8.1×108/LMNC. Results: Granulocyte engraftment occurred on day+12, platelet engrafted on day+14. Bone marrow biopsy showed normalization of trilineage hematopoiesis on day+33, chimerism: 97.6%. The transplantation was successful and followed up for 7 years with CR. Conclusion: Allo-HSCT might cure patients with refractory/relapsed HHV8+ MCD.

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Remissions of different quality following rituximab, tocilizumab and rituximab, and allogeneic stem cell transplantation in a patient with severe idiopathic multicentric Castleman’s disease

Cited by 7 publications

References 10 publications

International, evidence-based consensus treatment guidelines for idiopathic multicentric Castleman disease

International, evidence-based consensus treatment guidelines for idiopathic multicentric Castleman disease

Insufficient evidence exists to use histopathologic subtype to guide treatment of idiopathic multicentric Castleman disease

A Case of Successful Allogeneic Hematopoietic Stem Cell Transplantation for HHV8-Positive Castleman’s Disease with a Review of the Literature

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