Successful long-term control of lymphomatous meningitis with intraventricular rituximab.
Most primary central nervous system lymphomas (PCNSL) are highly malignant B-cell non-Hodgkin lymphomas. First-line therapy consists of high-dose methotrexate-based chemotherapy with or without whole brain radiotherapy. However, no standard of care is defined for refractory or recurrent PCNSL. We report a patient with lymphomatous meningitis, which was refractory to standard treatment but was successfully controlled for more than 6 years with intraventricular rituximab. Apart from two infections of the Ommaya reservoir, no severe side effects of intraventricular long-term treatment could be detected. This report indicates that intraventricular administration of rituximab might be beneficial in select patients with refractory or recurrent lymphomatous meningitis.
Department of Neurology, Klinikum Großhadern, Ludwig-Maximilians-University, Marchioninistr. 15, Munich 81377, Germany. Electronic address: tobias.birnbaum@med.uni-muenchen.de.
Tobias
T
Birnbaum
Department of Neurology, Klinikum Großhadern, Ludwig-Maximilians-University, Marchioninistr. 15, Munich 81377, Germany.
Louisa von
Lv
Baumgarten
Schoen-Klinik Bad Aibling, Bad Aibling, Germany.
Christine
C
Dudel
Department of Neurology, Klinikum Großhadern, Ludwig-Maximilians-University, Marchioninistr. 15, Munich 81377, Germany.
Andreas
A
Straube
D058846:Antibodies, Monoclonal, Murine-Derived / Q000009:adverse effects / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001921:Brain / Q000187:drug effects / Q000473:pathology; D001932:Brain Neoplasms / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D007276:Injections, Intraventricular; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D055756:Meningeal Carcinomatosis / Q000188:drug therapy* / Q000209:etiology* / Q000473:pathology; D008582:Meningitis, Aseptic / Q000188:drug therapy* / Q000209:etiology; D008875:Middle Aged; D000069283:Rituximab; D013997:Time Factors
D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000069283:Rituximab
Intrathecal; Intraventricular; Lymphomatous meningitis; PCNSL; Rituximab