Table 2

KSHV-associated MCD response criteria

Response categoryResponse and criteria
Clinical response CR 
     Full resolution of all signs and symptoms attributable to MCD, lasting 1 cycle (3-4 wk depending on regimen); requires normalization of involved nodal areas on physical examination 
 SFD 
     Full resolution of all symptoms attributable to MCD 
 PR 
     Improvement in at least 50% of signs and symptoms by at least 1 grade (NCI-CTCAE, Version 3), with no increased MCD-related increases, lasting 1 cycle (3-4 wk depending on regimen) 
 SD 
     No change in signs and symptoms of MCD meeting criteria for CR, PR, or PD 
 PD 
     Worsening of 2 or more symptoms by at least 1 grade 
Biochemical response* CR 
     Normalization of abnormalities attributed to MCD in the following laboratory values: hemoglobin, platelets, albumin, sodium, and CRP, lasting 1 cycle (3-4 wk depending on regimen) 
 PR 
     At least 50% improvement in all laboratory value abnormalities attributable to MCD, lasting 1 cycle (3-4 wk depending on regimen) 
 SD 
     No change in biochemical parameters that meet criteria for CR, PR, or PD 
 PD 
     ≥ 25% and 1 grade worsening of at least 2 biochemical parameters attributable to MCD OR clear deterioration in one parameter with negative impact on physiologic or health status 
Radiographic response CR 
     Normalization of all lymph nodes to < 1.5 cm in greatest transverse dimension, with decrease to < 1 cm of lymph nodes that measure 1.1-1.5 cm at baseline, or 75% decrease in SPD of measured lymph nodes; spleen < 12 cm greatest dimension, no pleural effusions 
 Cru 
     Residual lymph node mass > 1.5 cm or spleen > 12 cm that has decrease by ≥ 75% and does not change over 1 y 
 PR 
     For lymph nodes, ≥ 50% decrease in SPD of 6 dominant nodes; for spleen, ≥ 50% decrease in longest transverse dimension 
 SD 
     Not meeting criteria for CR, CRu, PR, or PD 
 PD 
     For lymph nodes, ≥ 25% increase in the SPD; for spleen, increase ≥ 25% in longest dimension 
Overall response CR 
     CR in all categories 
 PR 
     PR or better in all categories 
 SD 
     SD or better in all categories 
 PD 
     Progression in any 1 category 
Response categoryResponse and criteria
Clinical response CR 
     Full resolution of all signs and symptoms attributable to MCD, lasting 1 cycle (3-4 wk depending on regimen); requires normalization of involved nodal areas on physical examination 
 SFD 
     Full resolution of all symptoms attributable to MCD 
 PR 
     Improvement in at least 50% of signs and symptoms by at least 1 grade (NCI-CTCAE, Version 3), with no increased MCD-related increases, lasting 1 cycle (3-4 wk depending on regimen) 
 SD 
     No change in signs and symptoms of MCD meeting criteria for CR, PR, or PD 
 PD 
     Worsening of 2 or more symptoms by at least 1 grade 
Biochemical response* CR 
     Normalization of abnormalities attributed to MCD in the following laboratory values: hemoglobin, platelets, albumin, sodium, and CRP, lasting 1 cycle (3-4 wk depending on regimen) 
 PR 
     At least 50% improvement in all laboratory value abnormalities attributable to MCD, lasting 1 cycle (3-4 wk depending on regimen) 
 SD 
     No change in biochemical parameters that meet criteria for CR, PR, or PD 
 PD 
     ≥ 25% and 1 grade worsening of at least 2 biochemical parameters attributable to MCD OR clear deterioration in one parameter with negative impact on physiologic or health status 
Radiographic response CR 
     Normalization of all lymph nodes to < 1.5 cm in greatest transverse dimension, with decrease to < 1 cm of lymph nodes that measure 1.1-1.5 cm at baseline, or 75% decrease in SPD of measured lymph nodes; spleen < 12 cm greatest dimension, no pleural effusions 
 Cru 
     Residual lymph node mass > 1.5 cm or spleen > 12 cm that has decrease by ≥ 75% and does not change over 1 y 
 PR 
     For lymph nodes, ≥ 50% decrease in SPD of 6 dominant nodes; for spleen, ≥ 50% decrease in longest transverse dimension 
 SD 
     Not meeting criteria for CR, CRu, PR, or PD 
 PD 
     For lymph nodes, ≥ 25% increase in the SPD; for spleen, increase ≥ 25% in longest dimension 
Overall response CR 
     CR in all categories 
 PR 
     PR or better in all categories 
 SD 
     SD or better in all categories 
 PD 
     Progression in any 1 category 

Data are based on signs and symptoms probably or definitely attributed to KSHV-MCD.

CR indicates complete response; SFD, symptom-free disease; PR, partial response; NCI-CTCAE, National Cancer Institute Common Terminology Criteria for Adverse Events; SD, stable disease; PD, progressive disease; SPD, sum products of the diameters; and Cru, complete response, unconfirmed.

*

Determination of partial or complete biochemical responses was not based on improvements in hemoglobin or platelet counts that occurred within 3 weeks (one cycle) of transfusions or growth factor support.

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