Trial reportAmerican journal of hematology2020
Insufficient evidence exists to use histopathologic subtype to guide treatment of idiopathic multicentric Castleman disease.
Trial report in American journal of hematology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- Bone marrow findings of idiopathic Multicentric Castleman disease: A histopathologic analysis and systematic literature review.Hematological oncology · 2022Pooled it
- Clinical spectrum of retroperitoneal Castleman disease: retrospective analysis of 59 cases in a single Chinese medical center.The Canadian journal of urology · 2026Article
- Distinct interleukin-6 production in IPL and TAFRO subtypes of idiopathic multicentric Castleman disease.Haematologica · 2026Article
- Elucidating the grading intricacies of idiopathic multicentric Castleman disease histopathology: a pathologist's perspective.American journal of clinical pathology · 2026Review
- Clusterin expression and germinal center morphometry help distinguish idiopathic multicentric castleman disease from select lymphadenopathies.Frontiers in immunology · 2026Article
- [This is how I diagnose Castleman's disease].Zeitschrift fur Rheumatologie · 2025Article
- International Consensus Histopathological Criteria for Subtyping Idiopathic Multicentric Castleman Disease Based on Machine Learning Analysis.American journal of hematology · 2025Article
- Exploring castleman disease in a cohort of hispanic patients: a recognition to its histopathology.Journal of hematopathology · 2025Article
- Characterizing the heterogeneity of Castleman disease and oligocentric subtype: findings from the ACCELERATE registry.Blood advances · 2025Article
- Castleman Disease-Still More Questions than Answers: A Case Report and Review of the Literature.Journal of clinical medicine · 2025Review
- Exploring the Clinical Diversity of Castleman Disease and TAFRO Syndrome: A Japanese Multicenter Study on Lymph Node Distribution Patterns.American journal of hematology · 2025Article
- Runt-related transcription factors: from pathogenesis to therapeutic targets in multiple-organ fibrosis.Frontiers in cell and developmental biology · 2025Review
- TAFRO Syndrome: Guidance for Managing Patients Presenting Thrombocytopenia, Anasarca, Fever, Reticulin Fibrosis, Renal Insufficiency, and Organomegaly.Biomedicines · 2024Review
- Unmet Clinical Needs in the Management of Idiopathic Multicentric Castleman Disease: A Consensus-based Position Paper From an ad hoc Expert Panel.HemaSphere · 2023Article
- CXCL13 is a predictive biomarker in idiopathic multicentric Castleman disease.Nature communications · 2022Article
- How we manage idiopathic multicentric Castleman disease.Clinical advances in hematology & oncology : H&O · 2022Article
- TAFRO syndrome with a fatal clinical course following BNT162b2 mRNA (Pfizer-BioNTech) COVID-19 vaccination: A case report.Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy · 2022Article
- The disease course of Castleman disease patients with fatal outcomes in the ACCELERATE registry.British journal of haematology · 2022Article
- International definition of iMCD-TAFRO: future perspectives.Journal of clinical and experimental hematopathology : JCEH · 2022Article
- Transcriptome and unique cytokine microenvironment of Castleman disease.Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
24 authors at 20 institutions in 10 countries.
Funding
Abstract
Idiopathic multicentric Castleman disease (iMCD) is a rare immunologic disorder characterized by systemic inflammation, multicentric lymphadenopathy, and organ dysfunction. Enlarged lymph nodes demonstrate a spectrum of characteristic but variable histopathologic features historically categorized into hyaline vascular (HV) (or hypervascular [HyperV] more recently), plasmacytic, or "mixed." Though the etiology is unknown, a pro-inflammatory cytokine storm, often involving interleukin-6 (IL-6), contributes to pathogenesis. Anti-IL-6 therapy with siltuximab is the only FDA- or EMA-approved treatment based on efficacy and safety in multiple studies. Importantly, no patients considered to have HV histopathology achieved the primary endpoint in the Phase II study. NCCN currently recommends siltuximab first-line for iMCD, except for patients considered to have HV histopathology. We investigated whether histopathologic subtype should guide siltuximab treatment decisions. Secondary analyses of clinical trial and real-world data revealed similar clinical benefit across histopathologic subtypes. Notably, only 18 of 79 patients in the Phase II study were consistently classified into histopathologic subtype by three independent review panels, demonstrating limited reliability to guide treatment decisions. Real-world data further demonstrate siltuximab's effectiveness in patients considered to have HV (or HyperV). Though histopathology is a critical component for diagnosis, there is insufficient evidence to guide treatment based solely on lymph node histopathologic subtype.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.