Cover art for podcast Blood & Cancer

Blood & Cancer

70 EpisodesProduced by MDedge Hematology OncologyWebsite

Interview-style hematology/oncology podcast from MDedge Hematology-Oncology. The show is hosted by Dr. David Henry with Pearls from Dr. Ilana Yurkiewicz for clinical hematology and oncology health care professionals. The information in this podcast is provided for informational and educational purpo… read more

37:12

Castleman disease: Dr. David Fajgenbaum chases his cure

David Fajgenbaum, MD, of the University of Pennsylvania, Philadelphia, is a pioneer in the research of Castleman disease and he’s a patient himself. He joins Blood & Cancer host David Henry, MD, of Pennsylvania Hospital, Philadelphia, to talk about the presentation of Castleman, available treatments, and his own patient journey.

Plus, in Clinical Correlation, Ilana Yurkiewicz, MD, of Stanford (Calif.) University, talks about compassion fatigue among friends and family of cancer patients.

This Week in Oncology

Time Stamps:

  • This week in Oncology (03:51)
  • Interview (07:24)
  • Clinical Correlation (34:15)

Show notes

Castleman disease is a group of disorders unified by certain histologic features, including:

  • Atrophic (B-cell depleted) germinal centers with wide mantle zones.
  • Increased number of plasma cells in the interfollicular space.
  • Increased number of blood vessels in the interfollicular space.

The disease can be subdivided into unicentric Castleman disease (UCD) or multicentric Castleman disease (MCD), based upon the extent of the lymph node involvement.

  • Multicentric Castleman is further subdivided into HHV8-associated and non HHV8-associated (idiopathic) disease.
    • Determination of HHV-8 status is very important for the selection of the appropriate therapeutic strategy.

The presentation of Castleman Disease may be similar to the presentation of lymphomas, including fatigue, night sweats, peripheral edema, pancytopenia, and disseminated lymphadenopathy.

  • The diagnosis depends on the unique histologic appearance after bone marrow biopsy is performed.
  • Patients with Castleman disease often require hospitalization given rapid progression of symptoms due to massive cytokine release.

MCD is a rare clinical entity, and to date, only one randomized controlled trial has been published to date (involving siltuximab).

Therapeutic options:

  • Unicentric Castleman disease
    • Effectively treated with surgical excision of enlarged lymph node.
  • Multicentric Castleman disease
    • Rituximab (anti-CD20 monoclonal antibody)
      • Has been used off-label as first-line treatment in HIV-positive/HHV-8-positive MCD, alone or in combination with conventional chemotherapeutics.
    • Siltuximab (anti-IL-6 monoclonal antibody)
      • Currently the only approved treatment of idiopathic MCD in the United States.
    • Tocilizumab (humanized IL-6 receptor antagonist)
      • Approved for treatment of idiopathic MCD in Japan.
    • Sirolimus (mTOR pathway inhibition)
      • Under investigation at the University of Pennsylvania for treatment of patients who have been refractory to IL-6 blockade.
    • Bortezomib (selective proteasome inhibitor) and Anakinra (IL-1 receptor antagonist)
      • A small number of case reports suggest these may be used in MCD.

 

Dr. Fajgenbaum can be reached at davidfa@pennmedicine.upenn.edu. More information about Castleman disease can be found at www.cdcn.org

Dr. Fajgenbaum’s memoir is Chasing My Cure: A Doctor’s Race to Turn Hope into Action

Show notes by Sugandha Landy, MD, resident in the department of internal medicine, University of Pennsylvania, Philadelphia.

 

For more MDedge Podcasts, go to mdedge.com/podcasts

Email the show: podcasts@mdedge.com

Interact with us on Twitter: @MDedgehemonc

Ilana Yurkiewicz on Twitter: @ilanayurkiewicz

 

 

Educational emoji reaction

Educational

Interesting emoji reaction

Interesting

Funny emoji reaction

Funny

Agree emoji reaction

Agree

Love emoji reaction

Love

Wow emoji reaction

Wow

Are you the creator of this podcast?

Verify your account

and pick the featured episodes for your show.

Listen to Blood & Cancer

RadioPublic

A free podcast app for iPhone and Android

  • User-created playlists and collections
  • Download episodes while on WiFi to listen without using mobile data
  • Stream podcast episodes without waiting for a download
  • Queue episodes to create a personal continuous playlist
RadioPublic on iOS and Android
Or by RSS
RSS feed
http://jcsopodcast.mdedge.libsynpro.com/radiopublic

Connect with listeners

Podcasters use the RadioPublic listener relationship platform to build lasting connections with fans

Yes, let's begin connecting
Browser window

Find new listeners

  • A dedicated website for your podcast
  • Web embed players designed to convert visitors to listeners in the RadioPublic apps for iPhone and Android
Clicking mouse cursor

Understand your audience

  • Capture listener activity with affinity scores
  • Measure your promotional campaigns and integrate with Google and Facebook analytics
Graph of increasing value

Engage your fanbase

  • Deliver timely Calls To Action, including email acquistion for your mailing list
  • Share exactly the right moment in an episode via text, email, and social media
Icon of cellphone with money

Make money

  • Tip and transfer funds directly to podcastsers
  • Earn money for qualified plays in the RadioPublic apps with Paid Listens