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Brief Communication: Rituximab in HIV-Associated Multicentric Castleman Disease.
- Source :
- Annals of Internal Medicine; 12/18/2007, Vol. 147 Issue 12, p836-W241, 5p, 2 Charts
- Publication Year :
- 2007
-
Abstract
- Background: HIV-associated multicentric Castleman disease is a rare lymphoproliferative disorder with marked systemic symptoms attributed to cytokine disarray. Many therapeutic approaches in small series of patients have proved largely unsuccessful to date. Objective: To investigate the efficacy and clinicopathologic variables associated with first-line treatment for HIV-associated multicentric Castleman disease with the anti-CD20 monoclonal antibody rituximab. Design: Single-group, open-label, phase II trial. Setting: 3 teaching hospitals in England. Patients: Previously untreated patients with histologically proven HIV-associated multicentric Castleman disease. Intervention: 4 infusions of rituximab, 375 mg per m<superscript>2</superscript> of body surface area, at weekly intervals. Measurements: Response was evaluated clinically and radiologically and by measuring plasma Kaposi sarcoma-associated herpesvirus viral load. Results: 21 consecutive patients (18 men) with plasmablastic multicentric Castleman disease were recruited. The median follow-up was 12 months (range, 1 to 49 months). One patient died before completing therapy, 20 achieved remission of symptoms, and 14 (67%) achieved a radiologic response. The overall and disease-free survival rates at 2 years were 95% (95% Cl, 86% to 100%) and 79% (Cl, 49% to 100%), respectively. Plasma acute-phase proteins, immunoglobulins, and Kaposi sarcoma-associated herpesvirus viral load decreased after rituximab therapy. The main adverse effect was reactivation of Kaposi sarcoma. Limitation: The study had no comparison group. Conclusion: Rituximab may be clinically valuable as initial therapy for HIV-associated multicentric Castleman disease. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 00034819
- Volume :
- 147
- Issue :
- 12
- Database :
- Complementary Index
- Journal :
- Annals of Internal Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 27961096
- Full Text :
- https://doi.org/10.7326/0003-4819-147-12-200712180-00003