OBJECTIVEThis study was to explore the characteristics of anemia in Castleman disease (CD).

METHODSClinical data were collected retrospectively to analyze the prevalence and characteristics of CD with anemia were analysed retrospectively, and different types of anemia and their therapeutic effects were evaluated.

RESULTSAnemia was observed in 13/33(39%) newly diagnosed CD patients, most of them was mild and normocytic. Incidence of anemia in multicentric CD (MCD) was higher than that in unicentric CD (UCD) (85% vs 10%, P<0.001). Most of CD patients with anemia presented systematic manifestations; moreover, they had higher levels of erythrocyte sedimentation and inflammatory indices, higher incidence of polyclonal hyperimmunoglobulinemia, and higher positive rate of autoantibodies than those without anemia (P<0.05). Except for 2 cases of autoimmune hemolytic anemia (AIHA) and 1 case of anemia secondary to hypersplenism, the anemia in the other 10 patients exhibited features similar to anemia of chronic disease (ACD), whose hemoglobin levels were negatively correlated with the serum levels of C reactive protein and fibrinogen (r -0.917 and -0.717, respectively, P<0.001). Anemia in UCD was cured by the removal of tumor. Yet, anemia in MCD was improved after systemic treatment with immunotherapy and/or chemotherapy.

CONCLUSIONSanemia with an inflammatory and immunologic mechanism presents as a common symptom in MCD, but also can be observed in UCD. In addition to occasional AIHA, anemia associated with CD mainly presents characteristics of ACD. Treatment for anemia in CD is mainly based on the control of primary disease.