Rituximab decreases the risk of lymphoma in patients with HIV-associated multicentric Castleman disease
Open Access
- 8 March 2012
- journal article
- Published by American Society of Hematology in Blood
- Vol. 119 (10), 2228-2233
- https://doi.org/10.1182/blood-2011-08-376012
Abstract
HIV-associated multicentric Castleman disease (MCD) is associated with a high risk of developing nonHodgkin lymphoma (NHL). Rituximab is effective in HIV-MCD, but its impact on NHL incidence remains unknown. From a single-center prospective cohort, 113 patients were identified with a diagnosis of HIV-MCD for the present study. To compare the incidence of NHL between patients who had received a rituximab-based treatment (R+ group) and those who had not (R− group), data were analyzed before and after matching on propensity scores and after multiple imputation. The mean follow-up was 4.2 years. In the R− group (n = 65), 17 patients developed NHL (incidence, 69.6 of 1000 person years). In the R+ group (n = 48), only 1 patient developed NHL (incidence, 4.2 of 1000 person years). Based on the propensity score-matching method, a significant decrease in the incidence of NHL was observed in patients who had been treated with rituximab (hazard ratio, 0.09; 95% confidence interval, 0.01-0.70). Ten Kaposi sarcoma (KS) exacerbations and 1 newly diagnosed KS were observed in 9 patients after rituximab therapy. Rituximab was associated with an 11-fold lower risk of developing lymphoma. KS exacerbation was the most challenging adverse event after rituximab therapy.Keywords
This publication has 25 references indexed in Scilit:
- Improved outcome with rituximab in patients with HIV-associated multicentric Castleman diseaseBlood, 2011
- Clinical Features and Outcome in HIV-Associated Multicentric Castleman's DiseaseJournal of Clinical Oncology, 2011
- Kaposi sarcoma-associated herpesvirus/human herpesvirus 8 and lymphoproliferative disordersJournal of Clinical Pathology, 2007
- Plasmablastic microlymphoma occurring in human herpesvirus 8 (HHV‐8)‐positive multicentric Castleman's disease and featuring a follicular growth patternAPMIS, 2007
- The latency-associated nuclear antigen of Kaposi sarcoma-associated herpesvirus induces B cell hyperplasia and lymphomaJCI Insight, 2006
- High incidence of Kaposi sarcoma–associated herpesvirus–related non-Hodgkin lymphoma in patients with HIV infection and multicentric Castleman diseaseBlood, 2002
- Kaposi sarcoma-associated herpesvirus infects monotypic (IgMlambda) but polyclonal naive B cells in Castleman disease and associated lymphoproliferative disordersBlood, 2001
- Distribution of human herpesvirus-8 latently infected cells in Kaposi’s sarcoma, multicentric Castleman’s disease, and primary effusion lymphomaProceedings of the National Academy of Sciences, 1999
- Multicentric Castlemanʼs disease in HIV infectionAIDS, 1996
- Kaposi's sarcoma-associated herpesvirus-like DNA sequences in multicentric Castleman's disease [see comments]Blood, 1995