Intrathecal therapy with rituximab in central nervous system involvement of post-transplant lymphoproliferative disorder.

Abstract:

:Post-transplant lymphoproliferative disorder (PTLD) caused by Epstein-Barr virus (EBV) is a severe complication in high-risk allogeneic hematopoietic stem cell transplant (HSCT) recipients. Central nervous system (CNS) involvement of PTLD is a very rare event in patients with HSCT. As no established standard therapy in CNS-EBV-PTLD is available, the aim of this study was analysis of the safety and efficacy of intrathecal rituximab therapy in a group of eight children and adolescents with CNS-EBV-PTLD. Seven patients responded to therapy: all clinical symptoms and EBV-DNA viral load resolved after a median 2 (range: 1-7) doses of rituximab. However, some magnetic resonance imaging (MRI) changes in brain scan persisted in two patients. In all patients, except one, no adverse events of the therapy were observed. In conclusion, intrathecal rituximab administration seems to be an effective and safe method of treatment of CNS-EBV-PTLD in pediatric stem cell recipients. We recommend this treatment modality for further investigation.

journal_name

Leuk Lymphoma

journal_title

Leukemia & lymphoma

authors

Czyzewski K,Styczynski J,Krenska A,Debski R,Zajac-Spychala O,Wachowiak J,Wysocki M

doi

10.3109/10428194.2012.718342

subject

Has Abstract

pub_date

2013-03-01 00:00:00

pages

503-6

issue

3

eissn

1042-8194

issn

1029-2403

journal_volume

54

pub_type

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