在一名HHV - 8阳性、HIV阴性患者中，使用缬更昔洛韦、利妥昔单抗和脂质体阿霉素使多中心Castleman病和卡波西肉瘤获得持久缓解。
Durable remission of both multicentric Castleman's disease and Kaposi's sarcoma with valganciclovir, rituximab and liposomal doxorubicin in an HHV-8-positive, HIV-negative patient.
作者信息
Murphy C, Hawkes E, Chionh F, Chong G
机构信息
Department of Medical Oncology, Austin Health, Heidelberg, VIC, Australia.
Olivia Newton-John Cancer Research Institute and School of Cancer Medicine, La Trobe University, Melbourne, VIC, Australia.
出版信息
J Clin Pharm Ther. 2017 Feb;42(1):111-114. doi: 10.1111/jcpt.12472. Epub 2016 Oct 28.
WHAT IS KNOWN AND OBJECTIVE
Human herpesvirus-8 (HHV-8)-positive, HIV-negative multicentric Castleman's disease is a rare lymphoproliferative disorder with no standardized treatment. Concurrent Kaposi's sarcoma, another HHV-8-related disease, is uncommon in HIV-negative patients. The role of antiviral therapy and rituximab in HIV-negative patients is not well established.
CASE DESCRIPTION
We report a case of a 5-year, durable remission of HHV-8-positive, HIV-negative comorbid multicentric Castleman's disease and Kaposi's sarcoma treated with long-term valganciclovir, following initial rituximab and liposomal doxorubicin.
WHAT IS NEW AND CONCLUSION
Currently, there is no defined role for antiviral therapy in the treatment of HIV-negative HHV-8-positive multicentric Castleman's disease and Kaposi's sarcoma. Ganciclovir followed by indefinite, continuous valganciclovir is thought to have contributed significantly to the durable response in this case.
已知信息与目的
人疱疹病毒8型（HHV - 8）阳性、HIV阴性的多中心Castleman病是一种罕见的淋巴增生性疾病，尚无标准化治疗方案。另一种与HHV - 8相关的疾病——卡波西肉瘤，在HIV阴性患者中并不常见。抗病毒治疗和利妥昔单抗在HIV阴性患者中的作用尚未明确。
病例描述
我们报告一例HHV - 8阳性、HIV阴性的合并多中心Castleman病和卡波西肉瘤的患者，在最初接受利妥昔单抗和脂质体阿霉素治疗后，长期使用缬更昔洛韦治疗，实现了5年的持久缓解。
新发现与结论
目前，抗病毒治疗在HIV阴性的HHV - 8阳性多中心Castleman病和卡波西肉瘤治疗中尚无明确作用。在该病例中，更昔洛韦后无限期持续使用缬更昔洛韦被认为对持久缓解起到了重要作用。
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