Natural History Study of KSHV-Associated Multicentric Castleman's Disease
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 195
- 试验地点
- 1
- 主要终点
- natural history of MCD
研究概览
简要总结
Background:
Kaposi s sarcoma herpes virus (KSHV) causes several kinds of cancer, Kaposi sarcoma (KS), a form of Multicentric Castleman s Disease (MCD) and a type of lymphoma known as Primary Effusion Lymphoma (PEL). These cancers can occur alone or at the same time in the same patient. MCD can cause a lot of symptoms and problems with various organs in the body, making patients feel quite unwell. If unrecognized, the disease can be fatal. Medications such as rituximab alone or in combination with chemotherapy may help treat MCD but there is little known about the long term effects and the natural course of MCD.
Objective:
To better understand the biology of KSHV-MCD to help identify how this disease causes illness and how cancer treatments known to be effective in MCD may help patients with this condition. This study also aims to help identify ways to treat the disease by providing other standard cancer treatments that would be useful to use to treat MCD based on what we know about this condition.
Eligibility:
People 18 years of age and older with KSHV-MCD.
Design:
Participants will be screened with:
Medical history
Physical exam
CT scan
Blood and heart tests
Participants will have an initial evaluation. This will include:
Review of participants symptoms and ability to perform their normal activities
Blood and urine tests
Imaging studies such as CT and PET scans. Participants may have a contrast agent injected into their arm.
Photographs to document skin lesions
Optional skin biopsy. For this, a small piece of the skin will be removed.
Optional lymph node needle biopsy
Optional samples of the fluid in the space around the lungs, intestines, or heart
Optional sample of the liquid that surrounds the brain and spinal cord
Saliva samples
DEXA scan to examine the bones
Questionnaires
Optional limb measurements or cognitive tests
Physicians will give participants recommendations about treatment.
After their initial evaluation and any treatment, participants will have additional visits. These will occur every 3 months for the first year, then every 6 months for the second year, and then once a year for up to 1 year.
详细描述
Background:
- Multicentric Castleman s disease (MCD) is a rare but lethal Kaposi s sarcoma-associated herpesvirus (KSHV) associated lymphoproliferative disorder with a historical median survival of 2 years. It occurs more often in HIV-infected individuals than those without HIV infection. The poor prognosis is not fully explained by the underlying HIV, as the HIV-negative cases appear to have little or no survival advantage over the HIV-positive cohort. The disease has no defined standard treatment and there is much to be learned about its pathogenesis and natural history with current treatments.
- Patients with KSHV-MCD may present with other KSHV-associated conditions such as Kaposi sarcoma (KS) and may develop primary effusion lymphoma (PEL) following their diagnosis, which may affect morbidity and mortality. It is not clear how these concurrent conditions develop simultaneously and over time.
- Since 2004, the HIV and AIDS Malignancy Branch (HAMB) has studied the natural history and assessed novel therapies for KSHV-MCD which has contributed to the development of at least two therapies that are now considered as first-line therapies: (1) rituximab plus liposomal doxorubicin and (2) high dose zidovudine plus valganciclovir.
- These therapies plus either rituximab alone or other rituximab-based therapies that have been developed over the last 15 years have resulted in durable responses in patients with KSHV-MCD and have substantially improved the prognosis of these patients.
- The longitudinal evaluations along with tissue sample collection, imaging studies, and participant reported outcomes will allow for the development of a better understanding of the natural history of this disease, and the development of the basis for more effective treatments.
Objective:
-To study and describe the natural history of KSHV-MCD
Eligibility:
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •INCLUSION CRITERIA:
- •Biopsy proven KSHV-associated MCD, confirmed in the Laboratory of Pathology (LP), CCR
- •Age >=18 years.
- •ECOG performance status <=4 (Karnofsky >=20%).
- •Ability of subject to understand and the willingness to sign a written informed consent document.
- •Participants may be co-enrolled in other protocols, including investigational studies to treat KSHV-associated malignancies.
排除标准
- •Any condition or set of circumstances that in the opinion of the investigators would make participation in this study unsafe or otherwise inappropriate for a given individual.
- •Pregnancy
研究组 & 干预措施
Cohort 1
Subjects with KSHV-associated MCD
结局指标
主要结局
natural history of MCD
时间窗: ongoing
clinical presentation, patterns of disease progression, therapeutic response, disease recurrence and participant overall survival
次要结局
- relapse-free survival(every 3 months for year 1, every 6 month for year 2, yearly from year 3)
- overall survival(every 3 months for year 1, every 6 month for year 2, yearly from year 3)
- concurrent KS or PEL evaluation(every 3 months for year 1, every 6 month for year 2, yearly from year 3)