Multicentric Castleman's disease in HIV patients: a single-center cohort diagnosed from 2008 to 2018

Area of Science:

• Infectious Diseases
• Hematology
• Immunology

Background:

• Castleman's disease (CD) is a rare lymphoproliferative disorder.
• Multicentric Castleman's disease (MCD) associated with HIV and HHV-8 presents unique management challenges.
• Limited data exists on therapeutic strategies for HIV- and HHV-8-positive MCD.

Purpose of the Study:

• To evaluate the management and therapeutic outcomes of HIV- and HHV-8-positive multicentric Castleman's disease (MCD).
• To present single-center experience with a cohort of patients diagnosed with HIV-associated MCD.

Main Methods:

• Retrospective, descriptive study of patients with MCD admitted between 2008-2018.
• Inclusion criteria: HIV diagnosis, clinical signs of MCD, and evidence of HHV-8.
• Data collected on patient demographics, treatment regimens, and clinical outcomes.

Main Results:

• Nine male patients with HIV-associated MCD were included.
• Rituximab was the primary first-line therapy, achieving symptom resolution in 6/9 patients.
• Other treatments included tocilizumab, splenectomy, and antiviral/targeted therapies with varying outcomes.
• Relapse rate was 44%, with 1-year and 3-year survival rates of 87.5% and 71.4%, respectively.

Conclusions:

• Rituximab demonstrates effectiveness as a first-line and retreatment option for HIV- and HHV-8-positive MCD.
• The efficacy of alternative therapies such as splenectomy and other immunotherapies requires further investigation in larger cohorts.