How We Manage Idiopathic Multicentric Castleman Disease

09/2022 Though treatment exists for iMCD, and the CDCN has discovered several of these, the optimal treatment path for patients is not always clear. Researchers at the CDCN recently published an article in Clinical Advances in Hematology Oncology that provide guidance on an evidence based treatment approach for iMCD. You can read more about this treatment path here.


We recommend first-line treatment with anti–inter- leukin 6 (anti–IL-6) for all patients with idiopathic multicentric Castleman disease. We recommend enrollment of all patients with the Castleman Disease Collaborative Network. For patients with severe disease, we recommend the accelerated weekly dosing of anti–IL-6 therapy in combination with high-dose corticosteroids with close monitoring and consideration of cytotoxic chemotherapy. In mild or moderate cases, we follow standard anti–IL-6 dosing schedules and consider clinical trial enrollment, rituximab, or other immune modulators for nonresponders.

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