Long-term remission in idiopathic Castleman's disease with tocilizumab followed by consolidation with high-dose melphalan--two case studies.

Abstract

Multicentric Castleman's disease (MCD) is an uncommon lymphoproliferative disorder, often associated with a clinically aggressive behavior. No standard treatment has been established, but patients are usually treated with lymphoma-type regimens such as rituximab or combination chemotherapy. Recently, immunotherapies targeting IL-6 have proven effective and have been approved for this indication. However, these agents require long-term administration. Here, we describe the clinical course of two patients, refractory to rituximab and chemotherapy, showing long-term remission (18 and 24 months), following an induction phase with tocilizumab (an anti-IL-6 receptor antibody) and a consolidative phase with high-dose melphalan accompanied by autologous stem cell support. This may prove to be an effective option for this group of patients with an orphan disorder.

• Authors: Mats Jerkeman, Ola Lindén
• Journal: European journal of haematology (Eur J Haematol) Vol. 96 Issue 5 Pg. 541-3 (May 2016) ISSN: 1600-0609 [Electronic] England
• PMID: 26256458 (Publication Type: Case Reports, Journal Article)
• Copyright: © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Chemical References

• Antibodies, Monoclonal, Humanized
• Antineoplastic Agents
• Biomarkers
• tocilizumab
• Melphalan

Topics

• Adult
• Antibodies, Monoclonal, Humanized (therapeutic use)
• Antineoplastic Agents
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Biomarkers
• Biopsy
• Castleman Disease (diagnosis, drug therapy)
• Consolidation Chemotherapy
• Female
• Humans
• Induction Chemotherapy
• Male
• Melphalan (administration & dosage)
• Middle Aged
• Tomography, X-Ray Computed
• Treatment Outcome