Chemotherapy for Castleman Disease

Chemotherapy (chemo) is the use of anti-cancer drugs that are injected into a vein or a muscle or are taken by mouth. These drugs enter the bloodstream and reach all areas of the body, making this treatment very useful for multicentric Castleman disease (CD). Chemo may be used alone, in combination with corticosteroids or other drugs, or combined with radiation therapy (called chemoradiation).

Many chemo drugs can be used to treat patients with multicentric CD. The drugs used most often include:

  • Carmustine
  • Cladribine
  • Chlorambucil
  • Cyclophosphamide
  • Doxorubicin
  • Etoposide
  • Melphalan
  • Vinblastine
  • Vincristine

Often several drugs are combined. Because CD is similar to lymphomas in many ways, doctors often use chemo combinations like those used for lymphoma. But because CD is so rare, there is not a lot of information on which chemo treatment is best or even how well it works.

Doctors give chemo in cycles, in which a period of treatment is followed by a rest period to give the body time to recover. Each chemo cycle generally lasts for several weeks. Most chemo treatments are given on an outpatient basis (in the doctor’s office or clinic or hospital outpatient department) but some might require a hospital stay. Sometimes a patient takes one drug combination for several cycles and then later is switched to a different one.

Possible side effects

Chemo drugs attack cells that are dividing quickly, which is why they work against cancer and diseases like CD. But other cells in the body, such as those in the bone marrow (where new blood cells are made), the lining of the mouth and intestines, and the hair follicles, also divide quickly. These cells can also be affected by chemo, which can lead to certain side effects.

The side effects of chemo depend on the type and dose of drugs given and the length of time they are taken. These side effects can include:

  • Hair loss
  • Mouth sores
  • Loss of appetite
  • Nausea and vomiting
  • Diarrhea
  • Increased risk of infections (due to a shortage of white blood cells)
  • Easy bruising and bleeding (due to a shortage of blood platelets)
  • Fatigue and weakness (due to a shortage of red blood cells)

Along with the risks above, some chemo drugs can cause other side effects. Ask your health care team about what side effects you can expect based on the specific drugs you will get. Be sure to tell your doctor or nurse if you do have side effects, as there are often ways to help with them. For example, drugs can be given to help prevent or reduce nausea and vomiting.

Even though Castleman disease is not a cancer, chemo is often used in much the same way as it is for cancer. To learn more, see Chemotherapy.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Lurain K, Yarchoan R, Uldrick TS. Treatment of Kaposi sarcoma herpes virus-associated multicentric Castleman disease. Cancer Sci. 2017;9 [Epub ahead of print]. 

National Cancer Institute. Physician Data Query (PDQ). AIDS-related lymphoma treatment. 10/02/2015. Accessed at:  on January 11, 2018. 

National Cancer Institute. Castleman disease. Accessed at on January 10, 2018. 

National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: B-cell lymphomas. v.7.2017. Accessed at  on January 11, 2018 . 

National Organization for Rare Disorders. Castleman disease. Accessed at on January 5, 2018. 

van Rhee F, Greenway A, Stone K. Treatment of idiopathic Castleman disease. Hematol Oncol Clin North Am. 2018;32(1):89-106. 

Last Revised: February 5, 2018

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