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Blood, 1 December 2001, Vol. 98, No. 12, pp. 3473-3475
BRIEF REPORT
Long-term remission of Kaposi sarcoma-associated
herpesvirus-related multicentric Castleman disease with anti-CD20
monoclonal antibody therapy
Mario Corbellino,
Giovanna Bestetti,
Chiara Scalamogna,
Sara Calattini,
Morena Galazzi,
Luca Meroni,
Daniele Manganaro,
Marco Fasan,
Mauro Moroni,
Massimo Galli, and
Carlo Parravicini
From the Institute of Infectious Diseases and Tropical
Medicine, University of Milan; and the First Division of Infectious
Diseases and the Department of Pathology, Luigi Sacco Hospital, Milan,
Italy.
Kaposi sarcoma-associated herpesvirus (KSHV)-related multicentric
Castleman disease (MCD) is potentially lethal. Growing evidence indicates that, as in Epstein-Barr virus-driven lymphoproliferative disorders after transplantation, KSHV DNA burden in peripheral blood
mononuclear cells (PBMCs) may represent the most accurate marker of
disease activity. This report describes a patient with human
immunodeficiency virus who was followed up clinically and by
quantitative polymerase chain reaction for KSHV DNA sequences in PBMCs
for more than 3 years following the diagnosis of KSHV-related MCD.
Therapy with the antiherpesvirus agent cidofovir, antihuman interleukin-6 antibody BE-8, antiblastic chemotherapy, and
combination antiretroviral agents did not achieve durable clinical or
virologic remission of the disease. By contrast, administration of the
anti-CD20 monoclonal antibody rituximab was well tolerated and allowed
a 14-month remission of clinical symptoms and KSHV viremia. Rituximab should be added to the therapeutic armamentarium for KSHV-related MCD.
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