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PET-CT dokumentovaná remise multicentrické formy Castlemanovy choroby po léčbě rituximabem
Popis případu a přehled literatury


Authors: Zdeněk Adam 1;  Petr Szturz 1;  Renata Koukalová 2;  Zdeněk Řehák 2;  Luděk Pour 1;  Marta Krejčí 1;  Lenka Šmardová 1;  Michal Eid 1;  Pavlína Volfová 1;  Zdeňka Čermáková 3;  Leoš Křen 4;  Filip Sokol 4;  Ivo Hanke 5;  Eva Michalková 1;  Zdeněk Král 1;  Jiří Mayer 1
Authors‘ workplace: Interní hematologická a onkologická klinika LF MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Jiří Mayer, CSc. 1;  Oddělení nukleární medicíny, centrum PET, RECAMO, Masarykova onkologického ústavu Brno, primář MUDr. Zdeněk Řehák, Ph. D. 2;  Oddělení klinické biochemie FN Brnoa Katedra laboratorních metod LF MU Brno, přednosta doc. MUDr. Milan Dastych, CSc., MBA 3;  Ústav patologie LF MU a FN Brno, pracoviště Bohunice, přednosta doc. MUDr. Leoš Křen, Ph. D. 4;  Chirurgická klinika LF MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Zdeněk Kala, CSc. 5
Published in: Vnitř Lék 2015; 61(3): 251-258
Category: Case Report

Overview

We describe a case of multicentric Castleman disease with generalized lymphadenopathy and splenomegaly, accompanied by typical B symptoms - loss of 15 kg, fever of non-infectious origin, night sweats, symptoms of anemia. Histological examination of the nodes with the highest accumulation of fluorodeoxyglucose, taken from mediastinum by thoracoscopy, revealed plasmocellular type of Castleman disease. Tests for HIV and human herpesvirus 8 (HHV-8) were negative. Three recurrences of herpes zoster indicating an alteration of immunity preceded the dia­gnosis of disease. Treatment was initiated with combination of thalidomide, dexamethasone, and cyclophosphamide. The response after 2 months therapy was not clear and patient doesn´t tolerated the therapy well. Therefore, this treatment was terminated and R-CHOP (Mabthera - rituximab, cyclophosphamide, adriamycin, vincristine, and prednisone) was selected as a second-line therapy. Lymphadenopathy and splenomegaly were reduced during the 2 cycles of treatment, however, serious infectious complications accompanied the therapy. Therefore, only use of Mabthera monotherapy 375 mg /m2 was administered in 28-day intervals. This treatment has shown efficacy and tolerability. PET-CT scan has demonstrated disappearance of lymphadenopathy and splenomegaly, in addition, normalized accumulation of fluorodeoxyglucose. Monotherapy with Mabthera has proved to be effective and well tolerated drug in this case. Currently, there are more effective therapeutic alternatives in multicentric Castleman disease: treatment with monotherapy of rituximab or in combination therapy with immunomodulatory drugs (thalidomide or lenalidomide, treatment with anti-IL-6 (siltuximab) or against its receptor (tocilizumab). In the case of ineffectiveness of one treatment option must be tested other alternative. In this case the therapy based on thalido­mide wasn´t successful, whereas the treatment with Mabthera has achieved disappearance of disease symptoms.

Key words:
Castleman disease – Mabthera – rituximab – siltuximab – thalidomide


Sources

1. Robinson D Jr, Reynolds M, Casper C et al. Clinical epidemiology and treatment patterns of patients with multicentric Castleman disease: results from two US treatment centres. Br J Haematol 2014; 165(1): 39–48.

2. Szturz P, Moulis M, Adam Z et al. Castlemanova choroba. Klin Onkol 2011; 24(6): 424–434.

3. Szturz P, Adam Z, Chovancová J et al. Lenalidomide: a new treatment option for Castleman disease. Leuk Lymphoma 2012; 53(10): 2089–2091.

4. Adam Z, Pour L, Krejčí M et al. Účinnost lenalidomidu u vzácných krevních chorob: u histiocytózy z Langerhansových buněk, multicentrické Castlemanovy choroby, POEMS syndromu, Erdheimovy Chesterovy choroby a angiomatózy. Popis případů a přehled literatury. Vnitř Lék 2012; 58(11): 856–866.

5. Castleman B, Towe VW. Case report of the Massachusetts General Hospital weekly clinicopathological exercises, fouded by Richard C Cabot. N Engl J Med 1954; 251(10): 396–400.

6. Gaba AR, Stein RS, Sweet DJ et al. Multicentric giant node hyperplasia. Am J Clin Pathol 1978; 69(1): 86–90.

7. Fajgenbaum DC, van Rhee F, Nabel CS. HHV-8 negative idiopathic multicentric Castleman disease: novel insight into biology pathogenesis and therapy. Blood 2014; 123(19): 2924–2933.

8. El-Osta J, Janku F. Successful treatment of Castleman disease with interleukin-1 receptor antagonist (Anakinra). Mol Cancer Ther 2010; 9(6): 1485–1488.

9. Cronin DM, Warnke RA. Castleman disease: an update on classification and the spectrum of associated lesions. Adv Anat Pathol 2009; 16(4): 236–246.

10. Dispenzieri A. POEMS syndrome: 2011 update on diagnosis, risk-stratification, and management. Am J Hematol 2011; 86(7): 591–601.

11. Ruwan KP, Parakramawansha C, Wijeweera I et al. A case of POEMS syndrome with mixed hyaline vascular and plasma cell type Castleman’s disease. Ceylon Med J 2009; 54(2): 68–69.

12. Misri R, Kharkar V, Dandale A et al. Multiple capillary hemangiomas: a distinctive lesion of multicentric Castleman’s disease and POEMS syndrome. Indian J Dermatol Venereol Leprol 2008; 74(4): 364–366.

13. Dispenzieri A. Castleman disease. Cancer Treat Res 2008; 142: 293–330.

14. Garcia T, Dafer R, Hocker S et al. Recurrent strokes in two patients with POEMS syndrome and Castleman’s disease. J Stroke Cerebrovasc Dis 2007; 16(6): 278–284.

15. Owens CL, Weir EG, Ali SZ. Cytopathologic findings in “POEMS” syndrome associated with Castleman disease. Diagn Cytopathol 2007; 35(8): 512–515.

16. Eisenbarth SC, Colegio OR, Iyer A et al. Images in neuro-oncology: a case of POEMS (Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal protein and Skin changes) in a patient with multicentric Castleman’s disease. J Neurooncol 2007; 81(2): 163–165.

17. Huang J, Wang L, Zhou W et al. Hyaline vascular Castleman disease associated with POEMS syndrome and cerebral infarction. Ann Hematol 2007; 86(1): 59–61.

18. Chronowski GM, Ha CS, Wilder RB et al. Treatment of unicentric and multicentric Castleman disease and the role of radiotherapy. Cancer 2001; 92(3): 670–676.

19. Wolf M, Van Offel JF, Van de Velde A et al. Multicentric plasma cell variant Castleman’s disease presenting with cutaneous vasculitis and pulmonary parenchymal involvement in a patient with ankylosing spondylitis: case report and review of the literature. Acta Clin Belg 2011; 66(4): 305–310.

20. Dham A, Peterson BA. Castleman disease. Curr Opin Hematol 2007; 14(4): 354–359.

21. Peker D, Martinez AE, Schwartz MA et al. Complete remission in 4 patients with human herpesvirus 8-associated multicentric Castleman disease using rituximab and liposomal doxorubicin, a novel chemotherapy combination. Clin Adv Hematol Oncol 2012; 10(3): 204–206.

22. Hoffmann C, Schmid H, Müller M et al. Improved outcome with rituximab in patients with HIV-associated multicentric Castleman disease. Blood 2011; 118(13): 3499–3503.

23. Fragasso A, Mannarella C, Ciancio A et al. Complete remission and virologic response to combined chemoimmunotherapy (R-CVP) followed by rituximab maintenance in HIV-negative, HHV-8 positive patient with multicentric Castleman disease. Leuk Lymphoma 2008; 49(11): 2224–2226.

24. Casquero A, Barroso A, Fernández Guerrero ML et al. Use of rituximab as a salvage therapy for HIV-associated multicentric Castleman disease. Ann Hematol 2006; 85(3): 185–187.

25. Ide M, Kawachi Y, Izumi Y et al. Long-term remission in HIV-negative patients with multicentric Castleman’s disease using rituximab. Eur J Haematol 2006; 76(2): 119–123.

26. Powles T, Stebbing J, Montoto S et al. Rituximab as retreatment for rituximab pretreated HIV-associated multicentric Castleman disease. Blood 2007; 110(12): 4132–4133.

27. Bestawros A, Michel R, Séguin C et al. Multicentric Castleman’s disease treated with combination chemotherapy and rituximab in four HIV-positive men: a case series. Am J Hematol 2008; 83(6): 508–511.

28. Buchler T, Dubash S, Lee V et al, Rituximab failure in fulminant multicentric HIV/human herpesvirus 8-associated Castleman’s disease with multiorgan failure: report of two cases. AIDS 2008; 22(13): 1685–1687.

29. Bower M, Veraitch O, Szydlo R et al. Cytokine changes during rituximab therapy in HIV-associated multicentric Castleman disease. Blood 2009; 113(19): 4521–4524.

30. Mian H, Leber B. Mixed variant multicentric Castleman disease treated with rituximab: case report. J Pediatr Hematol Oncol 2010; 32(8): 622.

31. Lee JP, Kim DK, Oh DY et al. Successfully treated multicentric Castleman’s disease with renal thrombotic microangiopathy using rituximab and corticosteroid. Clin Nephrol 2011; 75(2): 165–170.

32. Gérard L, Bérezné A, Galicier L et al . Prospective study of rituximab in chemotherapy-dependent human immunodeficiency virus associated multicentric Castleman’s disease: ANRS 117 CastlemaB Trial. J Clin Oncol 2007; 25(22): 3350–3356.

33. Gérard L, Michot JM, Burcheri S et al. Rituximab decreases the risk of lymphoma in patients with HIV-associated multicentric Castleman disease. Blood 2012; 119(19): 2228–2233.

34. Ramasamy K, Gandhi S, Flowers MT et al. Rituximab and thalidomide combination therapy for Castleman Disease. Br J Haematol 2012; 158(3): 421–423.

35. Stary G, Kohrgruber N, Herneth AM et al. Complete regression of HIV-associated multicentric Castleman disease treated with rituximab and thalidomide. AIDS 2008; 22(10): 1232–1234.

36. Wang X, Ye S, Xiong C et al. Successful treatment with bortezomib and thalidomide for POEMS syndrome associated with multicentric mixed-type Castleman’s disease. Jpn J Clin Oncol 2011; 41(10): 1221–1224.

37. Hess G, Wagner V, Kreft A et al. Effects of bortezomib on pro-inflammatory cytokine levels and transfusion dependency in a patient with multicentric Castleman disease. Br J Haematol 2006; 134(5): 544–545.

38. Sobas MA, Alonso Vence N, Diaz Arias J et al. Efficacy of bortezomib in refractory form of multicentric Castleman disease associated to POEMS syndrome (MCD-POEMS variant). Ann Hematol 2010; 89(2): 217–219.

39. Fishman SJ, Feins NR, D’Amato RJ et al. Long-term remission of Crohn’s disease treated with thalidomide: a seminal case report. Angiogenesis 1999; 3(3): 201–204.

40. Lee FC, Merchant SH. Alleviation of systemic manifestations of multicentric Castleman’s disease by thalidomide. Am J Hematol 2003; 73(1): 48–53.

41. Starkey CR, Joste NE, Lee FC. Near-total resolution of multicentric Castleman disease by prolonged treatment with thalidomide. Am J Hematol 2006; 81(4): 303–304.

42. Kim SY, Lee SA, Ryoo HM et al. Thalidomide for POEMS syndrome. Ann Hematol 2006; 85(8): 545–546.

43. Wang X, Ye S, Xiong C et al. Successful treatment with bortezomib and thalidomide for POEMS syndrome associated with multicentric mixed-type Castleman’s disease. Jpn J Clin Oncol 2011; 41(10): 1221–1224.

44. Menegato MA, Canelles MF, Tonutti E et al. Remission of nephrotic syndrome after thalidomide therapy in a patient with Castleman’s disease. Clin Nephrol 2004; 61(5): 352–356.

45. Miltenyi Z, Toth J, Gonda A et al. Successful immunomodulatory therapy in castleman disease with paraneoplastic pemphigus vulgaris. Pathol Oncol Res 2009; 15(3): 375–381.

46. Zhao X, Shi R, Jin X et al. Diffuse hyperpigmented plaques as cutaneous manifestation of multicentric Castleman disease and treatment with thalidomide: report of three cases. J Am Acad Dermatol 2011; 65(2): 430–432.

47. Jung CP, Emmerich B, Goebel FD et al. Successful treatment of a patient with HIV-associated multicentric Castleman disease (MCD) with thalidomide. Am J Hematol 2004; 75(3): 176–177.

48. Galeotti C, Boucheron A, Guillaume S et al. Sustained remission of multicentric Castleman disease in children treated with tocilizumab, an anti-interleukin-6 receptor antibody. Mol Cancer Ther 2012; 11(8): 1623–1626.

49. Yuzuriha A, Saitoh T, Koiso H et al. Successful treatment of autoimmune hemolytic anemia associated with multicentric Castleman disease by anti-interleukin-6 receptor antibody (tocilizumab) therapy. Acta Haematol 2011; 126(3): 147–150.

50. Higuchi T, Nakanishi T, Takada K et al. A case of multicentric Castleman’s disease having lung lesion successfully treated with humanized anti-interleukin-6 receptor antibody, tocilizumab. J Korean Med Sci 2010; 25(9): 1364–1367.

51. Arita Y, Sakata Y, Sudo T et al. The efficacy of tocilizumab in a patient with pulmonary arterial hypertension associated with Castleman’s disease. Heart Vessels 2010; 25(5): 444–447.

52. Song SN, Tomosugi N, Kawabata H et al. Down-regulation of hepcidin resulting from long-term treatment with an anti-IL-6 receptor antibody (tocilizumab) improves anemia of inflammation in multicentric Castleman disease. Blood 2010; 116(18): 3627–3634.

53. Nishimoto N, Terao K, Mima T et al. Mechanisms and pathologic significances in increase in serum interleukin-6 (IL-6) and soluble IL-6 receptor after administration of an anti-IL-6 receptor antibody, tocilizumab, in patients with rheumatoid arthritis and Castleman disease. Blood 2008; 112(10): 3959–3964.

54. Williams SC. First IL-6-blocking drug nears approval for rare blood disorder. Nat Med 2013; 19(10): 1193.

55. Liu YC, Stone K, van Rhee F. Siltuximab for Multicentric Castleman disease. Expert Rev Hematol 2014; 7(5): 545–557.

56. van Rhee F, Fayad L, Voorhees P et al. Siltuximab, a novel anti-interleukin-6 monoclonal antibody, for Castleman’s disease. J Clin Oncol 2010; 28(23): 3701–3702.

57. Kurzrock R, Voorhees PM, Casper C et al. A phase I, open-label study of siltuximab, an anti-IL-6 monoclonal antibody, in patients with B-cell non-Hodgkin lymphoma, multiple myeloma, or Castleman disease. Clin Cancer Res 2013; 19(13): 3659–3670.

58. Szturz P, Adam Z, Řehák Z et al. Castlemanova choroba: retrospektivní studie léčebných výsledků u 10 pacientů z jednoho centra. Klin Onkol 2013; 26(2): 124–134.

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