Fatal course after administration of rituximab in a boy with relapsed all: a case report and review of literature.
We are reporting on a 14-year-old boy with a very early relapse of pre-B acute lymphoblastic leukemia (ALL) and anaplastic astrocytoma WHO degrees III; the astrocytoma was subtotally resected and subsequently treated with irradiation and chemotherapy. The leukemic relapse was refractory to the administered salvage therapy. Therefore, treatment with the human anti-CD20 monoclonal antibody (MoAb) IDEC-C2B8 (rituximab) was initiated. After a small fraction of the standard dose (375 mg/m(2)) had been administered, the infusion had to be interrupted because of an acute attack of pain in the lumbar region. Two days later, after resumption of the therapy, he developed a fatal course of systemic inflammatory response syndrome (SIRS) and died, possibly due to uncontrollable cytokine release syndrome associated with sepsis. The fatal course will be discussed based on a review of the literature.
Seifert
Georg
G
Charité, Universitätsmedizin Berlin, Germany. georg.seifert@charite.de
Reindl
Tobias
T
Lobitz
Stephan
S
Seeger
Karl
K
Henze
Guenter
G
D000293:Adolescent; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001254:Astrocytoma / Q000188:drug therapy*; D001853:Bone Marrow / Q000473:pathology; D001932:Brain Neoplasms / Q000188:drug therapy*; D002051:Burkitt Lymphoma / Q000188:drug therapy*; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D012008:Recurrence; D000069283:Rituximab
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000069283:Rituximab