Castleman's disease-a two compartment model of HHV8 infection

Klaus Martin Schulte*, Nadia Talat

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

54 Citations (Scopus)

Abstract

Castleman's disease is a primary infectious disease of the lymph node that causes local symptoms or a systemic inflammatory syndrome. Histopathology reveals a destroyed lymph node architecture that can range from hyaline-vascular disease to plasma-cell disease. Viral interleukin 6 (vIL-6) produced during the replication of human herpesvirus type 8 (HHV8) is the key driver of systemic inflammation and cellular proliferation. Stage progression of Castleman's disease results from switches between viral latency and lytic replication, and lymphatic and hematogenous spread. Multicentric plasma-cell disease in HIV-1 patients is associated with HHV8 infection. Polyclonal plasmablast proliferation escapes control in the germinal center with eventual malignant transformation into non-Hodgkin lymphoma. Surgery produces excellent results in unicentric disease, while multicentric disease responds to anti-CD20 therapy or IL-6 and chemotherapy. Lymphovascular endothelium and naive B cells are infectious reservoir-opening options for antiangiogenic and anti-CD19 strategies to enhance outcomes in patients with systemic disease.

Original languageEnglish
Pages (from-to)533-543
Number of pages11
JournalNature Reviews Clinical Oncology
Volume7
Issue number9
DOIs
Publication statusPublished - Sept 2010
Externally publishedYes

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