Sustained Remission of More Than 5 Years After Thalidomide-Cyclophosphamide-Prednisone Discontinuation in Idiopathic Multicentric Castleman Disease: A Single-Centre Retrospective Study

Idiopathic multicentric Castleman disease (iMCD) is a rare, potentially fatal lymphoproliferative disorder.Anti-interleukin-6 (IL-6) therapy is recommended as first-line treatment[1] 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 guidelines[4-5].Patients were included based on Castleman Disease Collaborative Network (CDCN) diagnostic criteria for iMCD[6], with disease severity (2/5 criteria) also defined by CDCN guidelines, and the idiopathic plasmacytic lymphadenopathy (IPL) subtype defined by Gao et al[7].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