利妥昔单抗鞘内注射成功治疗肾胰联合干细胞移植后中枢神经系统淋巴增殖性疾病
Successful treatment of central nervous system lymphoproliferative disorder in a kidney-pancreas and stem cell transplanted patient using intrathecal rituximab.
机构信息
Oncology, Division Hematology, Hopitaux Universitaires de Geneve, Geneva, Switzerland
Oncology, Division Hematology, Hopitaux Universitaires de Geneve, Geneva, Switzerland.
出版信息
BMJ Case Rep. 2021 Aug 5;14(8):e238236. doi: 10.1136/bcr-2020-238236.
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.
摘要
中枢神经系统淋巴组织增生性疾病（CNS-PTLD）是器官移植后的一种独特的临床病理实体，与生存率低有关。当中枢神经系统受累时，由于其对中枢神经系统的穿透性差，静脉注射利妥昔单抗可能不是首选治疗方法。然而，在一些小型研究和病例系列中，鞘内（IT）给予利妥昔单抗已被证明是安全有效的。我们在此报告一例肾胰联合移植后晚期发生中枢神经系统 PTLD 的患者，该患者在手术切除和四个周期 IT 利妥昔单抗治疗后达到完全缓解，并对该治疗选择进行了文献复习。
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