Brief communication: rituximab in HIV-associated multicentric Castleman disease.
Ann Intern Med
; 147(12): 836-9, 2007 Dec 18.
Article
em En
| MEDLINE
| ID: mdl-18087054
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 m2 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% CI, 86% to 100%) and 79% (CI, 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.
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Base de dados:
MEDLINE
Assunto principal:
Infecções por HIV
/
Hiperplasia do Linfonodo Gigante
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Fatores Imunológicos
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Anticorpos Monoclonais
Tipo de estudo:
Clinical_trials
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Ann Intern Med
Ano de publicação:
2007
Tipo de documento:
Article
País de afiliação:
Reino Unido