A rare case of multicentric castleman's disease transforms into multiple myeloma and its successful treatment

ABSTRACT

Multicentric Castleman's disease (MCD) is a rare kind of lymphoproliferative disorder characterized by systemic problems such as frequent fever, fatigue and weight loss with angiofollicular lymph node hyperplasia. However, unlike unicentric Castleman's disease (UCD) with long-time survival by surgery and local radiotherapy, MCD remains poor prognosis due to no well-defined optimal treatment strategies and high risk of developing malignances especially lymphoma. We reported a case of MCD who received chemotherapy by ECHOP with unsatisfactory outcome and then oral administration with thalidomide combined with prednisone without disease progression after therapy. After 3 y, his MCD turned into multiple myeloma (MM) and accompanied by obvious response to combination of thalidomide with prednisone. Nowadays, there is no standard of therapy yet established for MCD. We successfully treated one such patient and found thalidomide based therapy may have a significant effect on MCD. We also proposed further researches with therapeutic potential about thalidomide for MCD.

KEYWORDS:

• Castleman disease
• multiple myeloma
• lymphoproliferative disorder
• plasmocyte
• thalidomide

Disclosure of potential conflicts of interest

No potential conflicts of interest were reported.

Acknowledgments

This work was supported by the Municipal Science and Technology Bureau of Nanjing under Grant (YKK13116). Special thanks to the Youcai Zhao and Shibin Cao for supplying photomicrographs.

Additional information

Funding

This work was supported by the Municipal Science and Technology Bureau of Nanjing under grant YKK13116.