A successful treatment of relapsed primary CNS lymphoma patient with intraventricular rituximab followed by high-dose chemotherapy with autologous stem cell rescue.
The prognosis for patients with primary central nervous system (CNS) lymphoma (PCNSL) who relapse after the initial response is usually poor. A standard treatment for relapsed PCNSL has not yet been identified because of the heterogeneity of the therapies employed and the lack of large, prospective clinical trials. We describe a 46-year-old relapsed PCNSL patient who was successfully treated with intraventricular applications of rituximab to minimize neurotoxicity, 2 cycles of salvage chemotherapy with etoposide, ifosfamide, and cytarabine (VIA) regimen and high-dose chemotherapy with autologous stem cell rescue. The high-dose chemotherapy consisted of bischloroethylnitrosourea, etoposide, cytarabine, and melphalan (BEAM) regimen. Partial remission was detected after intraventricular rituximab therapy and the patient has been in complete remission without evidence of neurotoxicity for 28 months after high-dose chemotherapy with autologous stem cell rescue. This case indicates a new appropriate treatment guideline in relapsed PCNSL patient after initial intensive chemo-radiotherapy.
Department of Internal Medicine, Yonsei University College of Medicine, Seodaemun-Gu, Seoul, Korea.
Sung Jin
SJ
Hong
Jin Seok
JS
Kim
Jong Hee
JH
Chang
Kyoung Min
KM
Kim
Soo Jeong
SJ
Kim
Hye Won
HW
Lee
June-Won
JW
Cheong
Seung Tae
ST
Lee
Yoo Hong
YH
Min
D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D016543:Central Nervous System Neoplasms / Q000188:drug therapy* / Q000628:therapy*; D003561:Cytarabine / Q000627:therapeutic use; D005047:Etoposide / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000627:therapeutic use; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000628:therapy*; D008875:Middle Aged; D000069283:Rituximab; D033581:Stem Cell Transplantation / Q000379:methods*
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D003561:Cytarabine; D000069283:Rituximab; D005047:Etoposide; D007069:Ifosfamide