Long-term remission of Kaposi sarcoma–associated herpesvirus-related multicentric Castleman disease with anti-CD20 monoclonal antibody therapy

2-Chloro-deoxyadenosine Induces Durable Complete Remission in Castleman's Disease but may Accelerate its Transformation to Non-Hodgkin's Lymphoma

“…2-CdA cannot prevent, and may even accelerate, the transformation of MCD into refractory NHL. Future studies are necessary to confirm the Corbellino et al (10) data on the role of anti-CD20 monoclonal antibody in the treatment of MCD, even in non-HIV patients, since it is less toxic than combined chemotherapy or 2-CdA. It is also important to consider the role of autologous or allogeneic bone marrow transplantation in MCD, since the transformation to lymphoproliferative disorders is usually associated with refractoriness to standard and salvage therapy.…”

“…Many therapies have included extended courses of high-dose glucocorticoids alone or in combination with vinca alkaloids, alkylating agents, azathioprine and monoclonal antibodies against IL-6 or 2-chloro-deoxyadenosine (2-CdA) (8,9). Considering that lymph nodes of patients with KSHV-related MCD specifically harbor the virus in B cells located in the mantle zone, which stain positively for the CD20 surface antigen, Corbellino et al (10) treated a MCD HIV-positive patient with a single dose of anti-CD20 monoclonal antibody, which was well tolerated and allowed a 14-month remission of clinical symptoms and KSHV viremia. Corbellino et al…”

Failure of rituximab in human immunodeficiency virus-associated multicentric Castleman disease

“…In the initial report, a single dose of rituximab was sufficient to allow a 14-month remission of clinical symptoms and HHV8 viremia [5]. In the second report, however, four doses of rituximab were administered to 4 patients and a single dose to 1 patient.…”

“…Since the first encouraging report of the efficacy of rituximab for the treatment of HIV-associated MCD, eight other patients have been reported [5][6][7][8]. In the initial report, a single dose of rituximab was sufficient to allow a 14-month remission of clinical symptoms and HHV8 viremia [5].…”

“…The measure of HHV-8 DNA in peripheral mononuclear cells can be used to follow disease activity and response to therapy [4]. Corbellino et al recently reported one case of long-term remission of MCD with rituximab in a patient with HIV infection [5]. We therefore wished to assess the benefit of rituximab in our 2 patients.…”