Gao Huixia, Zhang Ningning, Zhou Chunju, Jin Ling, Yang Jing, Huang Shuang, Zhang Meng, Li Nan, Wang Tianyou, Duan Yanlong
Medical Oncology Department, Pediatric Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
National Key Clinical Discipline of Pediatric Hematology, Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline of Pediatrics (Capital Medical University), Beijing, China.
Ann Hematol. 2025 May 5. doi: 10.1007/s00277-025-06386-y.
Isolated central nervous system (CNS) involvement due to posttransplantation proliferative disorder (PTLD) is even rarer, with only a few cases reported in the literature. CNS involvement in patients with mature B-cell non-Hodgkin's (NHL) and PTLD confers a significantly worse prognosis as compared to patients without CNS lymphoma disease. Treatment of CNS lymphoma (CNSL) is challenging due to resistance to conventional cytotoxic and intrathecal chemotherapy. Here, we report the successful use of intrathecal rituximab in two pediatric cases of CD20 + isolated CNSL that had failed to respond to standard chemotherapy, intravenous rituximab and Epstein-Barr virus (EBV)-specific cellular therapy. However, after repeated intrathecal administration of rituximab, both patients' clinical symptoms were alleviated, which has created opportunities for further treatments. We emphasise that intrathecal rituximab may be a safe and promising strategy for the treatment of pediatric patients with CD20 + isolated CNSL. The literature on this topic was also reviewed.
移植后增殖性疾病（PTLD）导致的孤立性中枢神经系统（CNS）受累更为罕见，文献中仅报道了少数病例。与无中枢神经系统淋巴瘤疾病的患者相比，成熟B细胞非霍奇金淋巴瘤（NHL）和PTLD患者的中枢神经系统受累预后明显更差。由于对传统细胞毒性和鞘内化疗耐药，中枢神经系统淋巴瘤（CNSL）的治疗具有挑战性。在此，我们报告了鞘内注射利妥昔单抗成功治疗两例CD20 + 孤立性CNSL儿科病例，这两例患者对标准化疗、静脉注射利妥昔单抗和爱泼斯坦-巴尔病毒（EBV）特异性细胞治疗均无反应。然而，在反复鞘内注射利妥昔单抗后，两名患者的临床症状均得到缓解，这为进一步治疗创造了机会。我们强调，鞘内注射利妥昔单抗可能是治疗CD20 + 孤立性CNSL儿科患者的一种安全且有前景的策略。本文还对该主题的文献进行了综述。
