Stephan J L, Le Deist F, Blanche S, Le Bidois J, Peuchmaur M, Lellouch-Tubiana A, Hirn M, Griscelli C, Fischer A
Unité d'Immunologie, Unité 132 INSERM, Hôpital des Enfants-Malades, Paris, France.
Transplantation. 1992 Aug;54(2):246-9. doi: 10.1097/00007890-199208000-00011.
A 9-month-old infant developed Epstein-Barr virus-induced lymphoproliferative syndrome with mediastinal and central nervous system localizations, associated with mediastinal tuberculosis, 5 months after heart transplantation. As a combination of anti-B cell antibodies (CD21- and CD24-specific) and recombinant interferon alpha 2b, given intravenously, was not effective on the central nervous system disease, the anti-CD21 antibody was infused intrathecally via an Ommaya reservoir. High local concentrations of monoclonal antibodies were achieved, with no adverse effects. A dramatic clinical response was obtained, with clearance of abnormal cells from the cerebrospinal fluid and a clear reduction in the abnormalities on the brain images. The patient is well 7 months later. This observation indicates that treatment of B lymphoproliferative syndrome with central nervous system localization is feasible using a nontoxic, local B cell-specific approach.
一名9个月大的婴儿在心脏移植5个月后发生了由 Epstein-Barr 病毒引起的具有纵隔和中枢神经系统定位的淋巴增殖综合征，并伴有纵隔结核。由于静脉注射的抗B细胞抗体（CD21和CD24特异性）与重组干扰素α2b联合使用对中枢神经系统疾病无效，因此通过Ommaya储液器鞘内注射抗CD21抗体。实现了单克隆抗体的高局部浓度，且无不良反应。获得了显著的临床反应，脑脊液中的异常细胞清除，脑部图像上的异常明显减少。7个月后患者情况良好。该观察结果表明，使用无毒的局部B细胞特异性方法治疗具有中枢神经系统定位的B淋巴增殖综合征是可行的。
