Blood Res.  2014 Dec;49(4):253-258. 10.5045/br.2014.49.4.253.

Clinical features and outcomes in patients with human immunodeficiency virus-negative, multicentric Castleman's disease: a single medical center experience

• Seo S
• Yoo C
• Yoon DH
• Kim S
• Park JS
• Park CS
• Huh J
• Suh C

• KMID: 2270683
• DOI: http://doi.org/10.5045/br.2014.49.4.253

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.

Keyword

Multicentric Castleman's disease; Giant lymph node hyperplasia; Angiofollicular lymphoid hyperplasia; Prognosis; HIV

MeSH Terms

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

Figure

• 

  Fig. 1 The Kaplan-Meier depicting overall survival. (A) Extravascular fluid accumulation symptoms and signs. (B) Disease extent using the Ann Arbor staging system.

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