Blood:巨淋巴结增生症!

2018-09-07 MedSci MedSci原创

Castleman病(CD,又称巨淋巴结增生症)是一组具有组织病理特异性的异质性血液病,表现为单区域或多区域淋巴结肿大(MCD)。MCD的部分病例是由人疱疹病毒-8(HHV-8)感染引起的,而其他病例为HHV-8阴性或特发性(iMCD)。由于尚无统一的治疗指南,iMCD的治疗充满挑战性,预后可能很差;而且系统性的研究较少,也无明确的缓解标准。为提高iMCD患者预后,Castleman病协会从10个

Castleman病(CD,又称巨淋巴结增生症)是一组具有组织病理特异性的异质性血液病,表现为单区域或多区域淋巴结肿大(MCD)。MCD的部分病例是由人疱疹病毒-8(HHV-8)感染引起的,而其他病例为HHV-8阴性或特发性(iMCD)。

由于尚无统一的治疗指南,iMCD的治疗充满挑战性,预后可能很差;而且系统性的研究较少,也无明确的缓解标准。

为提高iMCD患者预后,Castleman病协会从10个国家邀请了42位专家组成国际工作组,根据已发表的文献、344例病例的治疗效果的综述和专家意见,来制定iMCD的管理指南

抗白介素-6单克隆抗体siltuximab(或托珠单抗)加上或不加上糖皮质激素,是iMCD首选的一线疗法。对于大多数重度病例,推荐辅助联合化疗。根据疾病的严重程度,推荐采用更多药物在治疗失败时作二三线疗法。制定缓解标准来促进评估治疗成功与否。制定的指南应该能帮助治疗医师根据疾病严重程度将患者分层,方便为患者选择最佳的治疗方案。

2016年10月已成立了CD患者的国际注册(ACCELERATE,NCT02817997),旨在收集患者的预后,积累治疗方案的选择依据。


原始出处:

Frits van Rhee, et al. International, evidence-based consensus treatment guidelines for idiopathic multicentric Castleman disease. Blood  2018  :blood-2018-07-862334;  doi: https://doi.org/10.1182/blood-2018-07-862334

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    2019-07-04 1de33e15m69(暂无匿称)

    我妈很不幸得了此病,在山西肿瘤山西大医院无法确诊,被建议北京协和送手术病理玻片,去上海广州的知名大医院进行病理会诊,以明确诊断,可是良性增生属假性淋巴瘤,严控体温升高,已经吃燕窝、壳寡糖和β葡聚糖,日常饮食特意藜麦和加拿大野米,亚马逊生命之油苦配巴油准备内服外抹杀灭疑似病毒。

    0

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    2018-09-09 sodoo