Intrathecal rituximab treatment for pediatric post-transplant lymphoproliferative disorder of the central nervous system.
Post-transplant lymphoproliferative disorder (PTLD) in the central nervous system (CNS) has a poor prognosis. New therapeutic approaches should be explored. We report our experience with intrathecal administration of rituximab in a 10-year-old kidney allograft recipient with PTLD in the CNS. After standard treatment had failed, we tried to treat the patient by administering rituximab directly into the cerebral ventricle through an Omaya reservoir, in addition to conventional intrathecal and systemic chemotherapy. This strategy resulted in a disappearance of clinical symptoms and a negative positron emission tomogram. Intrathecal administration of rituximab may be a feasible approach in children with PTLD in the CNS. However, its specific role in our patient remains uncertain.
Department of Pediatric Hematology and Oncology, University Medical Centre St Radboud, Nijmegen, The Netherlands.
Gretha
G
van de Glind
Siebold
S
de Graaf
Christoph
C
Klein
Marlies
M
Cornelissen
Britta
B
Maecker
Jan
J
Loeffen
D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000821:virology; D002648:Child; D020031:Epstein-Barr Virus Infections / Q000150:complications; D005260:Female; D006801:Humans; D007276:Injections, Intraventricular; D007278:Injections, Spinal; D016030:Kidney Transplantation / Q000009:adverse effects*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy* / Q000821:virology; D009404:Nephrotic Syndrome / Q000601:surgery; D011183:Postoperative Complications; D000069283:Rituximab
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000069283:Rituximab