Rituximab therapy for CNS lymphomas: targeting the leptomeningeal compartment

Blood ◽  
2003 ◽  
Vol 101 (2) ◽  
pp. 466-468 ◽  
Author(s):  
James L. Rubenstein ◽  
Dan Combs ◽  
Jay Rosenberg ◽  
Arthur Levy ◽  
Michael McDermott ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Hodgkin Lymphoma ◽  
Phase 1 ◽  
Central Nervous System Lymphoma ◽  
Serum Levels ◽  
Pharmacokinetic Analysis ◽  
Lymphomatous Meningitis ◽  
Cell Surface Molecule ◽  
Non Hodgkin Lymphoma

Most lymphomas that involve the central nervous system are B-cell neoplasms that express the cell surface molecule CD20. After intravenous administration, rituximab can be reproducibly measured in the cerebrospinal fluid (CSF) in patients with primary central nervous system lymphoma; however, the CSF levels of rituximab are approximately 0.1% of serum levels associated with therapeutic activity in patients with systemic non-Hodgkin lymphoma. Because lymphomatous meningitis is a frequent complication of non-Hodgkin lymphoma, we have conducted an analysis of the safety and pharmacokinetics of direct intrathecal administration of rituximab using cynomolgus monkeys. No significant acute or delayed toxicity, neurologic or otherwise, was detected. Pharmacokinetic analysis suggests that drug clearance from the CSF is biphasic, with a terminal half-life of 4.96 hours. A phase 1 study to investigate the safety and pharmacokinetics of intrathecal rituximab in patients with recurrent lymphomatous meningitis will be implemented based on these findings.

scholarly journals RARE-29. PRIMARY CENTRAL NERVOUS SYSTEM NON-HODGKIN LYMPHOMA IN AN 11-YEAR-OLD BOY: A CASE REPORT

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii448-iii448
Author(s):  
Jorge Luis Ramírez-Melo ◽  
Regina M Navarro-Martin del Campo ◽  
Manuel D Martinez-Albarran ◽  
Fernando Sánchez-Zubieta ◽  
Ana L Orozco-Alvarado ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Hodgkin Lymphoma ◽  
Central Nervous System Lymphoma ◽  
Complete Response ◽  
High Dose ◽  
Illustrative Case ◽  
Tumor Biopsy ◽  
Non Hodgkin Lymphoma ◽  
The Right

Abstract BACKGROUND Primary central nervous system lymphoma (PCNSL) are very rare in children. CLINICAL CASE: An 11-year-old male presented with a 2 months history with myoclonic movements in the upper right limb, and a sudden frontal headache, gait disturbance due to right hemiparesis and an ipsilateral convulsive episode. Upon admission he had critical condition, with hypertensive skull syndrome, Glasgow of 12, Karnofsky 40%, right hemiparesis, swallowing disorder, facial paralysis, and loss of photo motor reflex and unilateral amaurosis. A CT and MRI showed a huge tumor mass in the left tempo-parietal region, infiltrating the white matter and shifting the midline. A Tumor biopsy was done, and reported diffuse small cell non-Hodgkin lymphoma of high-grade, Burkitt type. Systemic lymphoma workup was negative. He received six cycles of chemotherapy based on high dose methotrexate, rituximab and triple intrathecal.After the second cycle an ophthalmologic evaluation was done, and found infiltration to the right retina, for which 6 cycles of intra vitreous chemotherapy with methotrexate were applied, he showed an excellent response, and recovered all his neurological functions except that right hemianopia persist. Control MRI showed partial response at 2nd cycle and complete response after the 4th cycle. No Radiation was performed. CONCLUSION This report highlights the fact that pediatric PCNSL may be effectively treated by a combination of HDMTX and rituximab-based chemoimmunotherapy without irradiation. Lack of awareness of this rare entity may lead to extense resections of brain, and potential permanent secuelae that were avoided in this illustrative case.

scholarly journals Secondary Central Nervous System Lymphoma as a Complication from a Systemic Non-Hodgkin Lymphoma

2021 ◽  
pp. 1-4
Author(s):  
Rodríguez-Leyva Ildefons ◽  
◽  
Rodríguez-Rivas Ricardo ◽  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Hodgkin Lymphoma ◽  
Systemic Disease ◽  
Brain Magnetic Resonance Imaging ◽  
Central Nervous System Lymphoma ◽  
B Cell Lymphoma ◽  
Non Hodgkin Lymphoma ◽  
Peripheral Nerve Involvement ◽  
Secondary Central Nervous System

Secondary central nervous system lymphoma is a complication from non-Hodgkin lymphoma not very well known. NHL can present in a variety of neurological clinical presentations varying from primary central nervous system lymphoma to complications from a systemic disease like metastasis or peripheral nerve involvement. We present a case of a 78-year-old male with Diffuse large B-cell lymphoma, treated with Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone. Six months later of the diagnosis, the patient presented to the emergency department, complaining of five days with progressive weakness in the left upper limb, and two days before the weakness developed in the left lower limb. On the neurologic examination with inattention, dysarthria, left central facial nerve palsy, severe weakness on the left hemibody with hyperreflexia, and left extensor plantar response. Brain Magnetic resonance imaging reported three metastatic lesions, with a final diagnosis of secondary central nervous system lymphoma.

scholarly journals P03.01 Secondary central nervous system lymphoma (SCNSL) in patient with non Hodgkin lymphoma (NHL): a case report

2019 ◽  
Vol 21 (Supplement_3) ◽  
pp. iii24-iii24
Author(s):  
E Susanti ◽  
N Suci Rahayu ◽  
M Fuad
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Case Report ◽  
Ct Scan ◽  
Hodgkin Lymphoma ◽  
Central Nervous System Involvement ◽  
Central Nervous System Lymphoma ◽  
Head Ct ◽  
System Involvement ◽  
Non Hodgkin Lymphoma

Abstract BACKGROUND non Hodgkin lymphoma (NHL) is a systemic cancer that originates from lymphocites. Central nervous system lymphoma is a rare form of non Hodgkin lymphoma that involve brain parenchym and spinal cord. The most common type of nervous system involvement is a leptomeningeal metastases. Whereas brain metastases is an extremely rare finding in NHL. We present a case report of NHL patient which metastasized to brain parenchym. MATERIAL AND METHODS Case report: a fourty two year old male patient suffered from seizure in September 2018, 7 days prior to hospitalized. severe headache and weakness on the left extremities were found in addition to seizure. A single nodule on the right frontal and another nodules on the right neck region were also found since 7 months ago. Patient was diagnosed with NHL in 2017 after a confirmed biopsy of NHL and underwent a chemotherapy procedure, but uncompleted. After head ct scan procedure in September 2018, which depicted a round mass in frontal lobe, patient underwent a complete chemotherapy procedure with CHOP regimen in September 2018. Another head ct scan was performed in January 2019 after a completed chemotherapy cycle which showed significant decrease in tumour size. RESULTS before and after head ct scan showed significant decrease in tumour size, from 4cmx2cm before chemotherapy and 2.5cmx1.3cm after chemotherapy CONCLUSION central nervous system involvement in NHL is a rare condition that carries a poor prognosis. Prophylaxis therapy still on debate about it’s efficacy to prevent this disease from spreading or relapse. Awareness of the possibility central nervous system involvement should always remain in a physician’s mind when dealing with NHL patients.

scholarly journals The Role of Rituximab in the Treatment of Primary Central Nervous System Lymphoma

Cancers ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1920
Author(s):  
Ruben Van Dijck ◽  
Jeanette K. Doorduijn ◽  
Jacoline E.C. Bromberg
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Hodgkin Lymphoma ◽  
Central Nervous System Lymphoma ◽  
High Dose ◽  
Non Hodgkin Lymphoma ◽  
The Central Nervous System ◽  
Cd20 Antibody ◽  
Anti Cd20

Primary central nervous system lymphoma (PCNSL) is a type of non-Hodgkin lymphoma limited to the central nervous system. It has a poor prognosis. Consensus has been reached on the treatment of newly diagnosed patients with high-dose methotrexate-based chemotherapy, but whether the addition of the monoclonal anti-CD20 antibody rituximab improves survival, as it does in systemic B-cell non-Hodgkin lymphoma, remains disputed. In this review, we reflect on the available evidence of the use of rituximab in PCNSL. Whether rituximab has any beneficial effect remains uncertain.

scholarly journals Primary central nervous system lymphoma

Hematology ◽  
2016 ◽  
Vol 2016 (1) ◽  
pp. 379-385 ◽  
Author(s):  
Tracy T. Batchelor
Keyword(s):  
Spinal Cord ◽  
Central Nervous System ◽  
Nervous System ◽  
Hodgkin Lymphoma ◽  
Central Nervous System Lymphoma ◽  
The Body ◽  
Immunocompetent Host ◽  
Non Hodgkin Lymphoma ◽  
Organ Specific ◽  
The Brain

Abstract Primary central nervous system lymphoma (PCNSL) is an extranodal non-Hodgkin lymphoma (NHL) confined to the brain, leptomeninges, eyes, or spinal cord. The majority of PCNSL cases occur in the immunocompetent host, the focus of this review. The prognosis of PCNSL is inferior to that of other NHL subtypes including other organ-specific subtypes of extranodal NHL. The 5- and 10-year survival proportions for PCNSL are 29.3% and 21.6%, respectively. The diagnosis and management of PCNSL differs from that of other primary brain cancers and NHL in other parts of the body.

scholarly journals Primary Central Nervous System Lymphoma in an Immunocompetent Patient Presenting as Multiple Cerebellar Lesions: A Case Report and Review of Literature

2019 ◽  
Vol 7 ◽  
pp. 232470961989354
Author(s):  
Gliceida M. Galarza Fortuna ◽  
Kathrin Dvir ◽  
Christopher Febres-Aldana ◽  
Michael Schwartz ◽  
Ana Maria Medina
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Brain Lesion ◽  
Central Nervous System Lymphoma ◽  
B Cell Lymphoma ◽  
Immunocompetent Patient ◽  
Cns Lymphoma ◽  
High Dose ◽  
Older Woman ◽  
Non Hodgkin Lymphoma

Primary central nervous system (CNS) lymphoma (PCNSL) is an uncommon extranodal non-Hodgkin lymphoma often presenting as a single brain lesion within the CNS. On histopathological evaluation of PCNSL a positive CD10, which is frequently observed in systemic diffuse large B-cell lymphoma, is present in approximately 10% of PCNSL. We describe a case of CD10-positive PCNSL presenting with multiple posterior fossa enhancing lesions in an immunocompetent older woman with a history of breast cancer successfully treated by the RTOG 0227 protocol consisting of pre-irradiation chemotherapy with high-dose methotrexate, rituximab, and temozolomide for 6 cycles, followed by low-dose whole-brain radiation and post-irradiation temozolomide.

Principles of paediatric radiation oncology

2013 ◽  
Author(s):  
Roger E Taylor
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Hodgkin Lymphoma ◽  
Radiation Oncology ◽  
Intensity Modulated Radiotherapy ◽  
Primitive Neuroectodermal Tumour ◽  
Paediatric Tumours ◽  
Intensity Modulated ◽  
Non Hodgkin Lymphoma ◽  
Central Nervous System Tumours

Chapter 15 discusses the principles of paediatric radiation oncology, and addresses quality assurance, chemotherapy/radiotherapy interactions, Leukaemia, Hodgkin lymphoma, Non-Hodgkin lymphoma, Neuroblastoma, Rhabdomyosarcoma, Ewing’s sarcoma/peripheral primitive neuroectodermal tumour, Osteosarcoma, central nervous system tumours, Intensity-modulated radiotherapy, and proton therapy for paediatric tumours.

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