Successful treatment of aggressive HIV-associated multicentric Castleman's disease: a case report. WMJ 2008 Jul;107(4):191-4
Date
08/16/2008Pubmed ID
18702436Scopus ID
2-s2.0-46849090934 (requires institutional sign-in at Scopus site) 8 CitationsAbstract
BACKGROUND: Multicentric Castleman's disease (MCD) in human immunodeficiency virus (HIV)-infected patients is an aggressive form of lymphoproliferative disorder that usually has a rapidly fatal outcome. Overall mortality is 70%-85%, and median survival is only 8-14 months. No standard or optimal therapy for MCD has been established.
CASE: A 49-year-old man with HIV infection presented with 1-week duration of low-grade fever, night sweats, left sided abdominal pain, and generalized weakness. Physical examination revealed a supraclavicular, anterior cervical and axillary lymphadenopathy, and splenomegaly. Excisional biopsy of the left axillary lymph node confirmed the diagnosis of an angiofollicular hyperplasia, or MCD, hyaline vascular type with CD20 positivity. Treatment included a combination of the chemotherapy regimen of cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) with the monoclonal anti-CD20 antibody rituximab. The chemotherapy was administered in parallel with highly active antiretroviral therapy (HAART). At a 3-year follow-up, the patient remains in complete remission and his HIV parameters have normalized with continued HAART.
CONCLUSION: This is the second publication describing the use of an aggressive combination of chemotherapy with rituximab in HIV-associated MCD. For an HIV patient with MCD, an aggressive treatment with full CHOP regimen combined with monoclonal anti-CD20 antibody rituximab should be considered, and the use of HAART does not need to be discontinued.
Author List
Flejsierowicz M, Ahmed MS, Kotov P, Cheng YCAuthor
Yee Chung Cheng MD Associate Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Antibodies, MonoclonalAntibodies, Monoclonal, Murine-Derived
Antineoplastic Combined Chemotherapy Protocols
Antiretroviral Therapy, Highly Active
Castleman Disease
Cyclophosphamide
Doxorubicin
HIV Infections
Humans
Male
Middle Aged
Prednisone
Rituximab
Tomography, X-Ray Computed
Vincristine
