We use cookies to understand how you use our site and to improve your experience. This includes personalizing content and advertising. To learn more, click here. By continuing to use our site, you accept our use of cookies. Cookie Policy.

Features Partner Sites Information LinkXpress hp
Sign In
Advertise with Us
PURITAN MEDICAL

Download Mobile App




Diagnostic Criteria for Multicentric Castleman Disease Published

By LabMedica International staff writers
Posted on 28 Feb 2017
An international panel of experts in pediatric and adult hematopathology, hematology/oncology, rheumatology, immunology, and infectious diseases has established the first set of diagnostic criteria for idiopathic multicentric Castleman disease (iMCD).

Multicentric Castleman disease involves hyperactivation of the immune system, excessive release of proinflammatory cytokines, proliferation of immune cells (B-cells and T-cells), and multiple organ system dysfunction. More...
Approximately 1,200 patients are diagnosed with iMCD each year in the United States. The disorder can occur in patients of any age, and about 35% of iMCD patients die within five years of diagnosis; 60% die within 10 years. In 2014, siltuximab, an anti-IL6 monoclonal antibody used to treat cancer, became the first [U.S.] Food and Drug Administration-approved iMCD therapy based on results from an international, randomized controlled trial in which 34% of patients had a complete or partial response to the drug compared to 0% on placebo.

Castleman disease must be distinguished from other disorders that can demonstrate "Castleman-like" lymph node features, including reactive lymph node hyperplasia, autoimmune disorders, and malignancies. Accurate diagnosis is challenging, as no standard diagnostic criteria or diagnostic biomarkers currently exist, and there is significant overlap with malignant, autoimmune, and infectious disorders. To correct the lack of diagnostic criteria, an international working group comprising 34 pediatric and adult pathology and clinical experts in iMCD and related disorders from eight countries, including two physicians that are also iMCD patients, was convened to establish iMCD diagnostic criteria. The working group reviewed data from 244 cases, met twice, and refined criteria over 15 months (June 2015 - September 2016).

The working group decided that for a diagnosis of iMCD to be made, two major criteria and at least two of 11 minor criteria are met, including at least one laboratory abnormality, such as anemia or elevated C-reactive protein in the blood. Additionally, several diseases with similar clinical presentation to iMCD must be excluded, such as another sub-type of CD called HHV-8-associated multicentric CD.

"Previously, patients had to hope their doctors were familiar with the Castleman disease medical literature in order for them to even consider an iMCD diagnosis," said first author David Fajgenbaum, assistant professor of medicine at the University of Pennsylvania. "Then, for the doctors considering the diagnosis, actually diagnosing it was very difficult. Now, with these criteria, doctors will know exactly what to look for and what to check off to feel confident about a diagnosis. The new criteria will accelerate time to diagnosis and, more importantly, administration of life-saving treatments for iMCD patients."

"I feel so pleased and optimistic that we are finally turning the tide against this disease," said Dr. Fajgenbaum. "I have heard of too many patients diagnosed with the disease only after they died and underwent an autopsy, and hopefully this will help doctors to diagnose it before it is too late."

Details of the diagnostic criteria were published in the January 13, 2017, online edition of the journal Blood.


New
Gold Member
Blood Gas Analyzer
Stat Profile pHOx
Serological Pipet Controller
PIPETBOY GENIUS
New
Gold Member
Automated Cell Culture Chemistry Analyzer
BioProfile FLEX2 Basic
New
Chlamydia Trachomatis Test
Aptima Chlamydia Trachomatis Assay
Read the full article by registering today, it's FREE! It's Free!
Register now for FREE to LabMedica.com and get access to news and events that shape the world of Clinical Laboratory Medicine.
  • Free digital version edition of LabMedica International sent by email on regular basis
  • Free print version of LabMedica International magazine (available only outside USA and Canada).
  • Free and unlimited access to back issues of LabMedica International in digital format
  • Free LabMedica International Newsletter sent every week containing the latest news
  • Free breaking news sent via email
  • Free access to Events Calendar
  • Free access to LinkXpress new product services
  • REGISTRATION IS FREE AND EASY!
Click here to Register








DIASOURCE (A Biovendor Company)

Channels

Hematology

view channel
Image: CitoCBC is the world first cartridge-based CBC to be granted CLIA Waived status by FDA (Photo courtesy of CytoChip)

Disposable Cartridge-Based Test Delivers Rapid and Accurate CBC Results

Complete Blood Count (CBC) is one of the most commonly ordered lab tests, crucial for diagnosing diseases, monitoring therapies, and conducting routine health screenings. However, more than 90% of physician... Read more

Immunology

view channel
Image: A simple blood test could replace surgical biopsies for early detecion of heart transplant rejection (Photo courtesy of Shutterstock)

Blood Test Detects Organ Rejection in Heart Transplant Patients

Following a heart transplant, patients are required to undergo surgical biopsies so that physicians can assess the possibility of organ rejection. Rejection happens when the recipient’s immune system identifies... Read more
Copyright © 2000-2025 Globetech Media. All rights reserved.