A successfully treated case of multicentric angiofollicular hyperplasia with oral chemotherapy (Castleman's disease)

Abstract

A case of angiofollicular lymph node hyperplasia of plasma cell type in a 60-year-old woman is reported. The patient presented with lymphadenopathy, splenomegaly, and fever. She responded dramatically to chlorambucil and corticosteroids and has remained free of disease for the last 30 months. The authors review and discuss the systemic cytotoxic treatment of this clinicopathologic entity.

The management of unicentric and multicentric Castleman's disease

“…Only anecdotal cases treated with a variety of single agents or combination regimens were found in the literature 19,20,[51][52][53][54][55][56][57][58] (Table 6). The use of high dose corticosteroids alone is associated with incomplete responses in most patients.…”

“…9,34 However, Pavlidis et al 54 report a complete remission in a single patient with multicentric-PC CD treated with chlorambucil and prednisone. As previously noted, the combination of polyneuropathy and the PC variant of CD has a poor prognosis.…”

A Case of Resected Plasma Cell Type Castleman’s Disease with Intramediastinal Lymph Nodes Spread

“…6,7) Anti-inflammatory analgesics, steroids, immunosuppressive agents, and anticancer drugs are mainly used for multicentric CD. [8][9][10] The availability of humanized anti-IL-6 receptor antibody for the type has also been reported recently. 11) On the other hand, treatment for localized CD is usually surgical resection because of the benign properties of this type.…”

Multicentric Castleman's disease treated with antivirals and immunosuppressants

“…Since chlorambucil and prednisone is an oral combination and is well tolerated, it should be considered early as a treatment option. Pavlidis et al [1990] describe successful treatment of MCD in a patient using an identical combination. This patient certainly did respond well to high doses of pulsed corticosteroids but continually exposing patients to such high doses of this medication is unrealistic given its numerous and varied side effects.…”