Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland.
Leuk Lymphoma. 2013 Mar;54(3):503-6. doi: 10.3109/10428194.2012.718342. Epub 2012 Aug 31.
Post-transplant lymphoproliferative disorder (PTLD) caused by Epstein-Barr virus (EBV) is a severe complication in high-risk allogeneic hematopoietic stem cell transplant (HSCT) recipients. Central nervous system (CNS) involvement of PTLD is a very rare event in patients with HSCT. As no established standard therapy in CNS-EBV-PTLD is available, the aim of this study was analysis of the safety and efficacy of intrathecal rituximab therapy in a group of eight children and adolescents with CNS-EBV-PTLD. Seven patients responded to therapy: all clinical symptoms and EBV-DNA viral load resolved after a median 2 (range: 1-7) doses of rituximab. However, some magnetic resonance imaging (MRI) changes in brain scan persisted in two patients. In all patients, except one, no adverse events of the therapy were observed. In conclusion, intrathecal rituximab administration seems to be an effective and safe method of treatment of CNS-EBV-PTLD in pediatric stem cell recipients. We recommend this treatment modality for further investigation.
移植后淋巴组织增生性疾病（PTLD）由 EBV 病毒引起，是高危异基因造血干细胞移植（HSCT）受者的严重并发症。PTLD 累及中枢神经系统（CNS）在 HSCT 患者中非常罕见。由于 CNS-EBV-PTLD 尚无标准的治疗方法，本研究旨在分析鞘内利妥昔单抗治疗 8 例 CNS-EBV-PTLD 儿童和青少年的安全性和疗效。7 例患者对治疗有反应：所有临床症状和 EBV-DNA 病毒载量在中位 2（范围：1-7）剂量利妥昔单抗治疗后均得到缓解。然而，2 例患者的脑部磁共振成像（MRI）扫描的一些变化仍然存在。除 1 例患者外，所有患者均未观察到治疗的不良反应。总之，鞘内利妥昔单抗给药似乎是治疗儿童干细胞受者 CNS-EBV-PTLD 的有效且安全的方法。我们建议对此治疗方法进行进一步研究。
