title: Improved outcome with rituximab in patients with HIV-associated multicentric Castleman disease.
abstract: Although HIV-associated multicentric Castleman disease (HIV-MCD) is not classified as an AIDS-defining illness, mortality is high and progression to lymphoma occurs frequently. At present, there is no widely accepted recommendation for the treatment of HIV-MCD. In this retrospective (1998-2010), multicentric analysis of 52 histologically proven cases, outcome was analyzed with respect to the use of different MCD therapies and potential prognostic factors. After a mean follow-up of 2.26 years, 19 of 52 patients died. Median estimated overall survival (OS) was 6.2 years. Potential risk factors, such as older age, previous AIDS, or lower CD4 T cells had no impact on OS. Treatment was heterogeneous, consisting of cytostatic and/or antiviral agents, rituximab, or combinations of these modalities. There were marked differences in the outcome when patients were grouped according to MCD treatment. Patients receiving rituximab-based regimens had higher complete remission rates than patients receiving chemotherapy only. The mean estimated OS in patients receiving rituximab alone or in combination with cytostatic agents was not reached, compared with 5.1 years (P = .03). Clinical outcome and overall survival of HIV-MCD have markedly improved with rituximab-based therapies, considering rituximab-based therapies (with or without cytostatic agents) to be among the preferred first-line options in patients with HIV-MCD.
authors.affiliation: Infektionsmedizinisches Centrum Hamburg, Hamburg, Germany. hoffmann@ich-hamburg.de
authors.forename: Christian
authors.initials: C
authors.lastname: Hoffmann
authors.forename: Holger
authors.initials: H
authors.lastname: Schmid
authors.forename: Markus
authors.initials: M
authors.lastname: Müller
authors.forename: Christian
authors.initials: C
authors.lastname: Teutsch
authors.forename: Jan
authors.initials: J
authors.lastname: van Lunzen
authors.forename: Stefan
authors.initials: S
authors.lastname: Esser
authors.forename: Timo
authors.initials: T
authors.lastname: Wolf
authors.forename: Christoph
authors.initials: C
authors.lastname: Wyen
authors.forename: Michael
authors.initials: M
authors.lastname: Sabranski
authors.forename: Heinz-August
authors.initials: HA
authors.lastname: Horst
authors.forename: Stefan
authors.initials: S
authors.lastname: Reuter
authors.forename: Martin
authors.initials: M
authors.lastname: Vogel
authors.forename: Hans
authors.initials: H
authors.lastname: Jäger
authors.forename: Johannes
authors.initials: J
authors.lastname: Bogner
authors.forename: Keikawus
authors.initials: K
authors.lastname: Arasteh
mesh_terms: D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000009:adverse effects / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D005871:Castleman Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D000069283:Rituximab; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000069283:Rituximab