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)

Most side effects improve once treatment is stopped, but some can last a long time or even be permanent. If your doctor plans treatment with chemo, be sure to discuss the drugs that will be used and the possible side effects.

If you get chemo, tell your doctor or nurse about any side effects as soon as you notice them. Your cancer care team can help you deal with them.. For example, drugs can be given before or along with chemo to help prevent or reduce nausea and vomiting.

Certain chemo drugs can have other, more specific side effects. For example, some can damage organs such as the kidneys or heart. Some of the drugs used to treat CD can cause nerve damage (known as peripheral neuropathy), leading to problems such as numbness and tingling in the hands and feet.

If you have serious side effects, the chemo might need to be reduced or stopped, at least for a short time. Your doctor will carefully monitor and adjust your drug doses because some side effects might be permanent.

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 the “Chemotherapy” section of our website.

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master's-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Last Medical Review: July 7, 2014 Last Revised: May 23, 2016

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