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  • Successful treatment of central nervous system lymphoproliferative disorder in a kidney-pancreas and stem cell transplanted patient using intrathecal rituximab

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Case report
Successful treatment of central nervous system lymphoproliferative disorder in a kidney-pancreas and stem cell transplanted patient using intrathecal rituximab
  1. Maria Anastasiou1,
  2. Anne-Claire Mamez1,
  3. Stavroula Masouridi1,
  4. Maria Isabel Vargas2,
  5. Karine Hadaya3,
  6. Kristof Egervari4 and
  7. Yves Chalandon1
  1. 1Oncology, Division Hematology, Hopitaux Universitaires de Geneve, Geneva, Switzerland
  2. 2Neuroradiology, Hopitaux Universitaires de Geneve, Geneva, Switzerland
  3. 3Nephrology, Hopitaux Universitaires de Geneve, Geneva, Switzerland
  4. 4Service of Clinical Pathology, Department of Genetic Medicine, Laboratory and Pathology, Hopitaux Universitaires de Geneve, Geneva, Switzerland
  1. Correspondence to Dr Maria Anastasiou; maria.anastasiou{at}hcuge.ch

Abstract

Central nervous system lymphoproliferative disorder (CNS-PTLD) after organ transplant is a unique clinicopathological entity and is associated with poor survival rates. When the CNS is involved, intravenous rituximab might not be the treatment of choice, due to its poor CNS penetration. However, intrathecal (IT) administration of rituximab has shown to be safe and efficient in small studies and in case series. We report here the case of a patient with late development of CNS-PTLD after kidney-pancreas transplantation who achieved complete remission after surgical resection and four cycles of IT rituximab and we provide a review of the literature for this treatment option.

  • haematology (drugs and medicines)
  • malignant disease and immunosuppression
  • neuroimaging
  • CNS cancer
  • haematology (incl blood transfusion)

https://doi.org/10.1136/bcr-2020-238236

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    Footnotes

    • Contributors Conception and design, planning, conducting, drafting lead, reporting, analysis and interpretation of data and discussion: MA. Discussion, editing, conception and design, contribution and review: A-CM and SM. Discussion, radiological part and assessments: MIV. Discussion, nephrological part and assessments: KH. Discussion, histopathological part and assessments: KE. Supervision, general direction, text review and feedback: YC.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.