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Oligocentric Castleman disease: clinical characteristics and surgical outcomes from a single-centre retrospective

Yukai Duan1, Xiang Gao1, Siyu Qian1

  • 1Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.

Frontiers in Immunology
|December 5, 2025
PubMed

Insights

Oligocentric Castleman Disease (OCD) patients show poorer survival than Unicentric CD. Surgery helps symptoms, but asymptomatic cases may benefit from active surveillance, while high-inflammatory types require tailored therapies.

Area of Science:

  • Hematology
  • Oncology
  • Rare Diseases

Background:

  • Oligocentric Castleman Disease (OCD) is an under-characterized subtype of Castleman Disease (CD).
  • OCD presents intermediate characteristics between Unicentric CD (UCD) and idiopathic Multicentric CD (iMCD).

Purpose of the Study:

  • To retrospectively analyze the clinical features, treatment outcomes, and prognosis of 100 CD patients, focusing on OCD.
  • To identify predictors of progression-free survival (PFS) in OCD patients.

Main Methods:

  • Retrospective analysis of 100 CD patients (63 UCD, 37 OCD).
  • Comparison of clinical characteristics, histology, inflammatory markers, and survival between UCD and OCD cohorts.
  • Subgroup analysis of OCD patients into asymptomatic and high-inflammatory groups.

Main Results:

  • OCD patients exhibited higher rates of mixed-type histology, elevated CRP/ESR, and significantly poorer PFS compared to UCD.
  • In the OCD cohort, debulking surgery or chemotherapy yielded an 80% complete response rate.
  • Plasmacytic type, non-contiguous lesions, extensive regional involvement, and high inflammatory markers predicted inferior PFS in OCD.

Conclusions:

  • Debulking surgery is effective for symptomatic OCD but may not be necessary for asymptomatic patients.
  • Hyper-inflammatory states in OCD predict relapse, necessitating careful treatment strategies.
  • Active surveillance may be suitable for asymptomatic OCD, while high-risk subgroups require novel therapeutic approaches.
Abstract

Keywords:
Castleman diseaseOligocentric Castleman diseasesurgerysurvival analysistreatment options

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