Clinical features and outcomes in patients with human immunodeficiency virus-negative, multicentric Castleman's disease: a single medical center experience.
- Author:
Seyoung SEO
1
;
Changhoon YOO
;
Dok Hyun YOON
;
Shin KIM
;
Jung Sun PARK
;
Chan Sik PARK
;
Jooryung HUH
;
Cheolwon SUH
Author Information
- Publication Type:Original Article
- Keywords: Multicentric Castleman's disease; Giant lymph node hyperplasia; Angiofollicular lymphoid hyperplasia; Prognosis; HIV
- MeSH: Ascites; Chungcheongnam-do; Diagnosis; Diaphragm; Edema; Fever; Follow-Up Studies; Giant Lymph Node Hyperplasia*; HIV; Humans; Hyalin; Korea; Male; Medical Records; Prognosis; Retrospective Studies; Seoul; Survival Rate
- From:Blood Research 2014;49(4):253-258
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND: Multicentric Castleman's disease (CD) is commonly associated with poor prognosis, and well-known prognostic factors are scarce. We performed a retrospective analysis to define the clinical features and prognostic factors for patients with multicentric CD. METHODS: Between 1990 and 2013, 32 patients with multicentric CD were identified from the database of the Asan Medical Center, Seoul, Korea. Clinicopathologic data were collected by reviewing the medical records. With the exclusion of 4 patients because of unknown human immunodeficiency virus infection status, 28 human immunodeficiency virus-negative patients with multicentric CD were included in this analysis. RESULTS: Most of the patients were male (76%) and had a median age of 54 years. Hyaline vascular variant was the most common subtype (N=11, 39%). Hepatosplenomegaly (61%), fever (39%), edema (29%), and ascites (18%) were the most frequently reported symptoms and signs at diagnosis. With a median follow-up of 67 months, the 5-year overall survival (OS) was 77%. Patients with extravascular fluid accumulation (i.e., peripheral edema, ascites, and/or pleural effusions) were significantly associated with a poor survival rate (5-year OS, 94% vs. 56%; P=0.04). The extent of disease involvement was also a significant prognostic factor (5-year OS, 91% for involvement on a single side vs. 73% on both sides of the diaphragm; P=0.03). Other clinicopathologic factors were not significantly associated with patient survival. CONCLUSION: Our findings suggest that the hyaline vascular variant is not a rare subtype of multicentric CD. Extravascular fluid accumulation and disseminated disease involvement seem to be significant prognostic factors.
