Successful treatment of EBV PTLD with CNS lymphomas with the monoclonal anti-CD20 antibody rituximab.
BACKGROUND
Posttransplant lymphoproliferative disease (PTLD) is a life-threatening complication after allogeneic hematopoietic stem cell (HSCT) or solid organ transplantation. The majority of PTLD are associated with the Epstein-Barr virus (EBV). PTLD may involve several organs like liver, lungs, kidney, spleen, and small intestine. PTLD with central nervous system (CNS) involvement only has been reported in very few cases so far.


METHODS
We here describe 2 cases who 7 and 12 months after HSCT developed EBV PTLD with CNS lymphomas only. The efficacy of therapy was monitored by magnetic resonance imaging, EBV replication, light chain detection, and the clinical course. Both patients responded very well to the intravenous administration of the monoclonal anti-CD20 antibody rituximab.


CONCLUSIONS
These 2 case reports illustrate that in EBV PTLD with CNS lymphomas, the systemic administration of rituximab only may prove effective.
Kordelas
Lambros
L
Department of Bone Marrow Transplantation, University Hospital Essen, Germany. lambros.kordelas@uk-essen.de
Trenschel
Rudolf
R
Koldehoff
Michael
M
Elmaagacli
Ahmet
A
Beelen
Dietrich W
DW
D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000276:immunology; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents / Q000008:administration & dosage; D001927:Brain Diseases / Q000188:drug therapy* / Q000209:etiology*; D020031:Epstein-Barr Virus Infections / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D008232:Lymphoproliferative Disorders / Q000188:drug therapy* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D000069283:Rituximab; D019737:Transplants / Q000009:adverse effects*; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D007155:Immunologic Factors; D000069283:Rituximab