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Long‐term remission in idiopathic Castleman's disease with tocilizumab followed by consolidation with high‐dose melphalan—two case studies
Author(s) -
Jerkeman Mats,
Lindén Ola
Publication year - 2016
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.12646
Subject(s) - medicine , rituximab , tocilizumab , melphalan , oncology , chemotherapy , refractory (planetary science) , lymphoma , surgery , disease , gastroenterology , physics , astrobiology
Multicentric Castleman's disease ( MCD ) is an uncommon lymphoproliferative disorder, often associated with a clinically aggressive behavior. No standard treatment has been established, but patients are usually treated with lymphoma‐type regimens such as rituximab or combination chemotherapy. Recently, immunotherapies targeting IL ‐6 have proven effective and have been approved for this indication. However, these agents require long‐term administration. Here, we describe the clinical course of two patients, refractory to rituximab and chemotherapy, showing long‐term remission (18 and 24 months), following an induction phase with tocilizumab (an anti‐ IL ‐6 receptor antibody) and a consolidative phase with high‐dose melphalan accompanied by autologous stem cell support. This may prove to be an effective option for this group of patients with an orphan disorder.