Birnbaum Tobias, Baumgarten Louisa von, Dudel Christine, Straube Andreas
Department of Neurology, Klinikum Großhadern, Ludwig-Maximilians-University, Marchioninistr. 15, Munich 81377, Germany.
Department of Neurology, Klinikum Großhadern, Ludwig-Maximilians-University, Marchioninistr. 15, Munich 81377, Germany.
J Clin Neurosci. 2014 Feb;21(2):356-8. doi: 10.1016/j.jocn.2013.03.033. Epub 2013 Sep 17.
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.
大多数原发性中枢神经系统淋巴瘤（PCNSL）是高度恶性的B细胞非霍奇金淋巴瘤。一线治疗包括基于大剂量甲氨蝶呤的化疗，可联合或不联合全脑放疗。然而，对于难治性或复发性PCNSL，尚无明确的标准治疗方案。我们报告了一名患有淋巴瘤性脑膜炎的患者，该患者对标准治疗无效，但通过脑室内注射利妥昔单抗成功控制病情超过6年。除了两次奥马亚贮液器感染外，未发现脑室内长期治疗的严重副作用。本报告表明，脑室内注射利妥昔单抗可能对某些难治性或复发性淋巴瘤性脑膜炎患者有益。
