دورية أكاديمية

Clinical and pathological characteristics of HIV- and HHV-8-negative Castleman disease.

التفاصيل البيبلوغرافية
العنوان: Clinical and pathological characteristics of HIV- and HHV-8-negative Castleman disease.
المؤلفون: Yu, Li, Tu, Meifeng, Cortes, Jorge, Xu-Monette, Zijun Y, Miranda, Roberto N, Zhang, Jun, Orlowski, Robert Z, Neelapu, Sattva, Boddu, Prajwal C, Akosile, Mary A, Uldrick, Thomas S, Yarchoan, Robert, Medeiros, L Jeffrey, Li, Yong, Fajgenbaum, David C, Young, Ken H
بيانات النشر: American Society of Hematology
سنة النشر: 2019
المجموعة: Duke University Libraries: DukeSpace
مصطلحات موضوعية: Humans, Herpesvirus 8, Human, HIV-1, Inflammation, Antibodies, Monoclonal, Disease-Free Survival, Immunophenotyping, Adolescent, Adult, Aged, Middle Aged, Female, Male, Young Adult, Castleman Disease
الوصف: Castleman disease (CD) comprises 3 poorly understood lymphoproliferative variants sharing several common histopathological features. Unicentric CD (UCD) is localized to a single region of lymph nodes. Multicentric CD (MCD) manifests with systemic inflammatory symptoms and organ dysfunction due to cytokine dysregulation and involves multiple lymph node regions. Human herpesvirus 8 (HHV-8) causes MCD (HHV-8-associated MCD) in immunocompromised individuals, such as HIV-infected patients. However, >50% of MCD cases are HIV and HHV-8 negative (defined as idiopathic [iMCD]). The clinical and biological behavior of CD remains poorly elucidated. Here, we analyzed the clinicopathologic features of 74 patients (43 with UCD and 31 with iMCD) and therapeutic response of 96 patients (43 with UCD and 53 with iMCD) with HIV-/HHV-8-negative CD compared with 51 HIV-/HHV-8-positive patients. Systemic inflammatory symptoms and elevated inflammatory factors were more common in iMCD patients than UCD patients. Abnormal bone marrow features were more frequent in iMCD (77.0%) than UCD (45%); the most frequent was plasmacytosis, which was seen in 3% to 30.4% of marrow cells. In the lymph nodes, higher numbers of CD3+ lymphocytes (median, 58.88 ± 20.57) and lower frequency of CD19+/CD5+ (median, 5.88 ± 6.52) were observed in iMCD patients compared with UCD patients (median CD3+ cells, 43.19 ± 17.37; median CD19+/CD5+ cells, 17.37 ± 15.80). Complete surgical resection is a better option for patients with UCD. Siltuximab had a greater proportion of complete responses and longer progression-free survival (PFS) for iMCD than rituximab. Centricity, histopathological type, and anemia significantly impacted PFS. This study reveals that CD represents a heterogeneous group of diseases with differential immunophenotypic profiling and treatment response.
نوع الوثيقة: article in journal/newspaper
وصف الملف: application/pdf
اللغة: English
تدمد: 0006-4971
1528-0020
العلاقة: Blood; blood-2016-11-748855; https://hdl.handle.net/10161/19333Test
الإتاحة: https://hdl.handle.net/10161/19333Test
رقم الانضمام: edsbas.7DECE511
قاعدة البيانات: BASE