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

J Clin Pharm Ther. 2017 Feb;42(1):111-114. doi: 10.1111/jcpt.12472. Epub 2016 Oct 28.

Abstract

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.

Keywords: Kaposi's sarcoma; human herpesvirus-8; multicentric Castleman's disease; rituximab; valganciclovir.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Agents / therapeutic use*
  • Antiviral Agents / therapeutic use
  • Castleman Disease / drug therapy*
  • Castleman Disease / virology
  • Doxorubicin / analogs & derivatives*
  • Doxorubicin / therapeutic use
  • Ganciclovir / analogs & derivatives*
  • Ganciclovir / therapeutic use
  • HIV Infections / drug therapy
  • Herpesviridae Infections / drug therapy
  • Humans
  • Male
  • Middle Aged
  • Polyethylene Glycols / therapeutic use
  • Rituximab / therapeutic use*
  • Sarcoma, Kaposi / drug therapy*
  • Sarcoma, Kaposi / virology
  • Valganciclovir

Substances

  • Antineoplastic Agents
  • Antiviral Agents
  • liposomal doxorubicin
  • Polyethylene Glycols
  • Rituximab
  • Doxorubicin
  • Valganciclovir
  • Ganciclovir

Supplementary concepts

  • Multi-centric Castleman's Disease