Multicentric Castleman's disease treated with combination chemotherapy and rituximab in four HIV-positive men: a case series

Multicentric Castleman's disease (MDC) is a rare herpesvirus-8-related prelymphomatous condition that may develop in patients infected with human immunodeficiency virus (HIV). Therapy for MCD is not well established and most often includes: corticosteroids, single or combined chemotherapy, anti-CD20 monoclonal antibody and antiretroviral therapy. In order to obtain a rapid and long-lasting clinical response, we are reporting on a short course of anthracycline-based chemotherapy associated with rituximab in HIV-positive patients with MCD. Our study suggests that the combined immuno-chemotherapy approach may represent a valid strategy with acceptable toxicity in patients with severe and extensive MDC. Further studies will be needed to assess the efficacy and safety of such an approach, and to identify risk factors predictive of long-term tolerance in HIV patients with different degrees of immunosuppression.