Idiopathic multicentric Castleman disease (iMCD) is a rare, potentially fatal lymphoproliferative disorder.Anti-interleukin-6 (IL-6) therapy is recommended as first-line treatment1 and often continuing indefinitely 2.Yet access constraints, limited response rates, and long-term burden raise the question of whether and when therapy can be stopped after non-IL-6-targeted regimens 3.We conducted a single-center retrospective study of newly diagnosed iMCD patients who received a fixed 2-year course of oral thalidomide-cyclophosphamide-prednisone (TCP) between July 2015 and December 2021, as recommended by National Comprehensive Cancer Network (NCCN) and Chinese guidelines4-5.Patients were included based on Castleman Disease Collaborative Network (CDCN) diagnostic criteria for iMCD6, with disease severity (2/5 criteria) also defined by CDCN guidelines, and the idiopathic plasmacytic lymphadenopathy (IPL) subtype defined by Gao et al7.Patients were excluded if they were still receiving treatment, suffered from disease progression during TCP regimen, switched to next treatment, discontinued treatment within 2 years or lost to follow-up.Responses
Dang et al. (2026) studied this question.