A successful treatment of relapsed primary CNS lymphoma patient with intraventricular rituximab followed by high-dose chemotherapy with autologous stem cell rescue

The prognosis for patients with primary central nervous system (CNS) lymphoma (PCNSL) who relapse after the initial response is usually poor. A standard treatment for relapsed PCNSL has not yet been identified because of the heterogeneity of the therapies employed and the lack of large, prospective...

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Published in:Yonsei medical journal 2009, 50(2), , pp.280-283
Main Authors: Hong, Sung Jin, Kim, Jin Seok, Chang, Jong Hee, Kim, Kyoung Min, Kim, Soo Jeong, Lee, Hye Won, Cheong, June-Won, Lee, Seung Tae, Min, Yoo Hong
Format: Article
Language:English
Subjects:
Antibodies, Monoclonal - therapeutic use
Antibodies, Monoclonal, Murine-Derived
Case Report
Central Nervous System Neoplasms - drug therapy
Central Nervous System Neoplasms - therapy
Cytarabine - therapeutic use
Etoposide - therapeutic use
Female
Humans
Ifosfamide - therapeutic use
Lymphoma, Non-Hodgkin - drug therapy
Lymphoma, Non-Hodgkin - therapy
Middle Aged
Rituximab
Stem Cell Transplantation - methods
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Summary:The prognosis for patients with primary central nervous system (CNS) lymphoma (PCNSL) who relapse after the initial response is usually poor. A standard treatment for relapsed PCNSL has not yet been identified because of the heterogeneity of the therapies employed and the lack of large, prospective clinical trials. We describe a 46-year-old relapsed PCNSL patient who was successfully treated with intraventricular applications of rituximab to minimize neurotoxicity, 2 cycles of salvage chemotherapy with etoposide, ifosfamide, and cytarabine (VIA) regimen and high-dose chemotherapy with autologous stem cell rescue. The high-dose chemotherapy consisted of bischloroethylnitrosourea, etoposide, cytarabine, and melphalan (BEAM) regimen. Partial remission was detected after intraventricular rituximab therapy and the patient has been in complete remission without evidence of neurotoxicity for 28 months after high-dose chemotherapy with autologous stem cell rescue. This case indicates a new appropriate treatment guideline in relapsed PCNSL patient after initial intensive chemo-radiotherapy.
ISSN:0513-5796
1976-2437
DOI:10.3349/ymj.2009.50.2.280