Malignancy (27.3%, 52/191)
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MISCONCEPTIONS
To colleagues who think iMCD is indolent, it’s important to remember that there is a broad spectrum of presentations.
DR. DAVID FAJGENBAUM
CO-FOUNDER OF THE CDCN
Our understanding of iMCD is constantly changing. It should not be considered an indolent disease but one that has a severe and rapid impact on patient quality of life. In a real-world, retrospective analysis of claims data, it was found that iMCD patients had a 49.9% increase in inpatient hospitalisations within the first year of diagnosis and a 32.8% increase in emergency room visits versus the database average*1
Within one-year of iMCD diagnosis, patients experienced:1
Respiratory Failure (6.8%, 13/191)
Renal Failure (12%, 23/191)
Thrombus (6.8%, 13/191)
WHEN TO TREAT
It is vital that iMCD is treated at the point of diagnosis as it associated with a poorer prognosis than many cancers. Patients with iMCD have poorer outcomes than many cancers including stage II colon cancer, stage III breast cancer and progressive non-Hodgkin’s lymphoma.2
WITHIN 2–5 YEARS OF iMCD DIAGNOSIS PATIENTS WILL CONTINUE TO EXPERIENCE:**1
-
Malignancy
(19.7–29.7%) -
Respiratory Failure
(1.9–7.4%) -
Renal Failure
(2.5–5.7%) -
Thrombus
(4.3–7.4%)
IMPORTANCE OF TIMELY MANAGEMENT
iMCD IS A CHRONIC DISEASE THAT PROGRESSES IN THE ABSENCE OF AN APPROPRIATE MANAGEMENT STRATEGY. IT IS THEREFORE VITAL TO START TREATMENT AS SOON AS POSSIBLE AS WITHOUT TREATMENT, THE DISEASE CAN LEAD TO SEVERE SYMPTOMS SUCH AS ORGAN DYSFUNCTION AND DEATH.3-5
BEFORE THE ERA OF TARGETED TREATMENT, APPROXIMATELY 35% OF PATIENTS WITH iMCD DIED WITHIN 5 YEARS OF DIAGNOSIS.6,7
EXPERT OPINIONS
-
03:52
Watch Dr. David Fajgenbaum give his insight around the importance of identifying and treating patients early.
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04:03
Dr. Fajgenbaum offers his full analysis on the retrospective claims analysis.
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03:46
The author of the real world analysis Dr. Mukherjee gives his analysis of the results of the landmark study.
* US population. Database averages are derived respectively from the average hospitalisation and emergency room visits for the entire database (n>30 million) over the 5-year period. In the population with iMCD, hospitalisation and emergency room visits were recorded annually over the 5-year period.
** Annual number of iMCD patients who experienced malignancy: year 2, n=32/162; year 3, n=27/106; year 4, n=16/79; year 5, n=16/54. Annual number of iMCD patients who experienced renal failure: year 2, n=8/162; year 3, n=6/106; year 4, n=2/79; year 5, n=2/54. Annual number of iMCD patients who experienced respiratory failure: year 2, n=6/162; year 3, n=2/106; year 4, n=5/79; year 5, n=4/54. Annual number of iMCD patients who experienced thrombus: year 2, n=7/162; year 3, n=5/106; year 4, n=4/79; year 5, n=4/54.
References
- Mukherjee S, et al. 2020. Poster presented at ASH.
- Sitenga J, et al. Patient Relat Outcome Meas. 2018; 9: 35-41.
- van Rhee F, et al. Blood. 2018; 132 (20): 2115-2125.
- Fajgenbaum DC. Blood. 2018; 132(22): 2323–2330.
- Yu L, et al. Blood. 2017; 129(12): 1658-1668.
- Fajgenbaum DC, et al. Blood. 2017; 129(12) 1646-1657.
- Dispenzieri A, et al. Am J Hematol. 2012; 87(11): 997-1002.
iMCD, idiopathic Multicentric Castleman Disease; US, United States.
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Date of prep: November 2021 GL-SIL-2100102
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