Marcelin Anne-Geneviève, Aaron Laurent, Mateus Christine, Gyan Emmanuel, Gorin Isabelle, Viard Jean-Paul, Calvez Vincent, Dupin Nicolas
Department of Virology, UPRES 2387, Pitié-Salpêtrière Hospital, Paris, France..
Blood. 2003 Oct 15;102(8):2786-8. doi: 10.1182/blood-2003-03-0951. Epub 2003 Jul 3.
To assess the clinical benefit of rituximab for HIV-associated Castleman disease, 5 patients infected with HIV with histologic-proven Castleman disease were prospectively enrolled to receive 4 infusions of rituximab. Clinical and biologic parameters (C-reactive protein, CD19 cell count, Kaposi sarcoma-associated herpesvirus [KSHV] viral load in peripheral blood mononuclear cells) were assessed before and at different time points following rituximab infusions. Two patients died very quickly after the beginning of rituximab therapy with no effect on both KSHV viral load and CD19 cell count. Three of 5 patients were considered in complete remission with no more clinical symptoms related to Castleman disease with a follow-up of 4 to 14 months. In 2 cases, clinical remission correlated with a dramatic decrease of KSHV viral load and C-reactive protein levels and a transitory but sharp decrease of CD19 cell count. In 2 responders, we observed an aggravation of Kaposi sarcoma. Our preliminary results suggest that rituximab may be effective in controlling Castleman disease in a subset of patients, although it may exacerbate concomitant Kaposi sarcoma.
为评估利妥昔单抗治疗人类免疫缺陷病毒（HIV）相关的卡波西肉瘤的临床疗效，前瞻性纳入了5例经组织学证实患有卡波西肉瘤的HIV感染患者，接受4次利妥昔单抗输注。在利妥昔单抗输注前及输注后的不同时间点评估临床和生物学参数（C反应蛋白、CD19细胞计数、外周血单个核细胞中卡波西肉瘤相关疱疹病毒[KSHV]病毒载量）。2例患者在利妥昔单抗治疗开始后很快死亡，KSHV病毒载量和CD19细胞计数均无变化。5例患者中有3例在随访4至14个月时被认为完全缓解，无更多与卡波西肉瘤相关的临床症状。在2例患者中，临床缓解与KSHV病毒载量和C反应蛋白水平显著降低以及CD19细胞计数短暂但急剧下降相关。在2例缓解患者中，我们观察到卡波西肉瘤病情加重。我们的初步结果表明，利妥昔单抗可能对部分患者控制卡波西肉瘤有效，尽管它可能会加重并发的卡波西肉瘤。
