Successful treatment of a patient with HIV‐associated multicentric Castleman disease (MCD) with thalidomide

Jung, Christoph; Emmerich, Bertold; Goebel, F.-D.; Bogner, Johannes R.

doi:10.1002/ajh.10467

Cited by 33 publications

(19 citation statements)

References 5 publications

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“…Remission continues on 300 mg daily 1 year into therapy. There is one case report of benefit of thalidomide in an HIV-positive patient with multicentric CD [50]. Standard dosage 50 to 400 mg by mouth nightly.…”

Section: Thalidomidementioning

confidence: 97%

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Treatment of castleman’s disease

Dispenzieri

Gertz

2005

Curr. Treat. Options in Oncol.

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Castleman's disease (CD) was first described in 1954 and further defined in 1956 by Castleman. Since then much has been learned about the heterogeneity of this condition. Subsequently, three pathologic classifications have been developed (hyaline vascular variant, plasma cell variant, and mixed variant) and two clinical classifications (unicentric [unifocal or localized] and multicentric [multifocal or generalized]). The pathology found with the unicentric presentation is most commonly that of the HV variant. It responds well to surgical resection and is associated with a benign course. The multicentric presentation is rarely composed of lymph nodes with HV pathology, but rather with the plasma cell or mixed pathology. This presentation requires systemic therapy and prognosis is guarded. Associated systemic symptoms are common. There is an increased incidence of CD in patients with HIV. The human herpes virus-8 is associated with nearly all of the HIV-associated CD cases and nearly 50% of non-HIV cases. Interleukin (IL)-6 has also been shown to play a significant role in the pathogenesis of the disease. Paraneoplastic and autoimmune entities are not uncommon in the disorder. Variable benefit has been achieved with single agent chemotherapy, combination chemotherapy, interferon (IFN)-alpha, rituximab, anti-IL-6 receptor antibodies, and thalidomide. Patients with CD are at increased risk for developing frank malignant lymphoma.

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Section: Thalidomidementioning

confidence: 97%

“…The drug has been used in HIV-associated multicentric CD with good effect in the limited case reports [50,58,59]. Scott et al [58] treated two HIV-positive patients diagnosed with aggressive multicentric CD with daily oral etoposide (50 mg).…”

Section: Oral Etoposidementioning

confidence: 99%

Treatment of castleman’s disease

Dispenzieri

Gertz

2005

Curr. Treat. Options in Oncol.

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“…10,12,39,43,[45][46][47][48][49][50][51][52][53][54][55] Although rapid resolution of symptoms has been reported in patients with active disease, relapses occur frequently and the progression-free survival is often brief. A strategy using maintenance oral etoposide (100-200 mg/m 2 , weekly) has been adopted in France.…”

Section: Chemotherapymentioning

confidence: 99%

How I treat HIV-associated multicentric Castleman disease

Bower

2010

Blood

117

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“…Successful treatment has been reported with various chemotherapeutic agents, including vincristine, vinblastine, etoposide, cyclophosphamide, and doxorubicin, alone or in combination 1,15 ; as well as with ganciclovir, 17 IFN-␣, 18,19 and thalidomide. 20,21 Steroids have been described to reduce inflammatory symptoms in MCD not associated with KSHV. 22 With all of these modalities, relapse is common.…”

Section: Introductionmentioning

confidence: 99%

High-dose zidovudine plus valganciclovir for Kaposi sarcoma herpesvirus-associated multicentric Castleman disease: a pilot study of virus-activated cytotoxic therapy

Uldrick

Polizzotto

Aleman

et al. 2011

Blood

132

103

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Kaposi sarcoma herpesvirus (KSHV)-associated multicentric Castleman disease (MCD) is a lymphoproliferative disorder most commonly observed in HIVinfected patients. It is characterized by KSHV-infected plasmablasts that frequently express lytic genes. Patients manifest inflammatory symptoms attributed to overproduction of KSHV viral IL-6, human IL-6, and human IL-6. There is no standard therapy and no established response criteria. We investigated an approach targeting 2 KSHV lytic genes, ORF36 and ORF21, the protein of which, respectively, phosphorylate ganciclovir and zidovudine to toxic moieties. In a pilot study, 14 HIV-infected patients with symptomatic KSHV-MCD received highdose zidovudine (600 mg orally every 6 hours) and the oral prodrug, valganciclovir (900 mg orally every 12 hours). Responses were evaluated using new response criteria. A total of 86% of patients attained major clinical responses and 50% attained major biochemical responses.

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Successful treatment of a patient with HIV‐associated multicentric Castleman disease (MCD) with thalidomide

Cited by 33 publications

References 5 publications

Treatment of castleman’s disease

Treatment of castleman’s disease

How I treat HIV-associated multicentric Castleman disease

High-dose zidovudine plus valganciclovir for Kaposi sarcoma herpesvirus-associated multicentric Castleman disease: a pilot study of virus-activated cytotoxic therapy

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