Treatment of Central Nervous System B Lymphoproliferative Syndrome by Local Infusion of a B Cell-Specific Monoclonal Antibody

Deist, Françoise Le; Blanche, S.; Bidois, J. Le; Lellouch‐Tubiana, Arielle; Hirn, M.; Griscelli, C; Fischer, Alain

doi:10.1097/00007890-199208000-00011

Cited by 37 publications

(10 citation statements)

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“…There is a report of one adult patient with CNS PTLD treated with 3 g/m 2 IV Mtx and dose‐adjusted ABCVP (doxorubicin reduced to 50 mg/m 2 , cyclophosphamide adjusted to renal function, vindesine, bleomycin and prednisone), and two others with renal dysfunction treated with dose‐adjusted ABVCP and cranial irradiation (Fohrer et al , 2006). Other treatments include rituximab, cidovidir, intrathecal Mtx and methylprednisolone in a case of CNS leukaemia (Nozzoli et al , 2006) and intrathecal administration of monoclonal antibodies in another case report (Stephan et al , 1992).…”

Section: Discussionmentioning

confidence: 99%

Efficacy and tolerability of high‐dose methotrexate in central nervous system positive or relapsed lymphoproliferative disease following liver transplant in children

et al. 2007

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SummaryChildhood post-transplant lymphoproliferative disease (PTLD) is a heterogeneous condition in which treatment varies, from the reduction of immunosuppression to moderately intensive chemotherapy. While lowdose chemotherapy/rituximab has been found to be effective, moderately intensive chemotherapy is required for patients who relapse, have classic nonHodgkin lymphoma or have fulminant PTLD. Methotrexate (Mtx) is highly effective in lymphomas and crosses the blood-brain barrier. However, there are no data in the literature regarding its safety in post-liver transplant patients. We describe four cases of high-grade lymphomas (three diffuse large B cell and one T-cell lymphoblastic), post-liver transplant, for which chemotherapy including high-dose Mtx (HDMTX) was the treatment of choice. In total, 20 doses of HDMTX (1-5 g/m 2 ) were given. The treatment was well tolerated and all four patients had a good response. One case of central nervous system (CNS) diffuse large B-cell lymphoma was treated with HDMTX alone. We conclude that, in the absence of significant organ damage, HDMTX can safely be given to liver transplant patients, but should only be administered in specialist oncology units. Proof of effectiveness as a single agent in CNS lymphoma needs further studies.

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Section: Discussionmentioning

confidence: 99%

Efficacy and tolerability of high‐dose methotrexate in central nervous system positive or relapsed lymphoproliferative disease following liver transplant in children

et al. 2007

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“…However, 69 patients treated with radiotherapy did not respond to treatment and died. There is a single case report of complete remission of CNS PTLD following intrathecal anti B cell antibody administered through an Ommaya reservoir (Stephan et al , 1992).…”

Section: Ptld Affecting the Central Nervous Systemmentioning

confidence: 99%

Management of post‐transplant lymphoproliferative disorder in adult solid organ transplant recipients – BCSH and BTS Guidelines

et al. 2010

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SummaryA joint working group established by the Haemato-oncology subgroup of the British Committee for Standards in Haematology (BCSH) and the British Transplantation Society (BTS) has reviewed the available literature and made recommendations for the diagnosis and management of post-transplant lymphoproliferative disorder in adult recipients of solid organ transplants. This review details the therapeutic options recommended including reduction in immunosuppression (RIS), transplant organ resection, radiotherapy and chemotherapy. Effective therapy should be instituted before progressive disease results in declining performance status and multi-organ dysfunction. The goal of treatment should be a durable complete remission with retention of transplanted organ function with minimal toxicity.

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“…Despite this the rate of death remained high in patients with posttransplant lymphoma. Therapeutic strategies targeting B cells (61), including local or systemic administration of specific anti-CD24-, anti-CD21-, and anti-CD20-(rituximab) B cell antibodies, were successful with a follow-up of several months (62,63). There are also reports of successful antiviral treatment with acyclovir, valacyclovir, or ganciclovir in EBV-induced lymphoproliferative disease (64).…”

Section: Management Of the Allograft Recipient With De Novo Malignancmentioning

confidence: 99%

Malignancy in Renal Transplantation

Morath¹,

Mueller²,

Goldschmidt³

et al. 2004

Journal of the American Society of Nephrology

193

115

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Treatment of Central Nervous System B Lymphoproliferative Syndrome by Local Infusion of a B Cell-Specific Monoclonal Antibody

Cited by 37 publications

References 0 publications

Efficacy and tolerability of high‐dose methotrexate in central nervous system positive or relapsed lymphoproliferative disease following liver transplant in children

Efficacy and tolerability of high‐dose methotrexate in central nervous system positive or relapsed lymphoproliferative disease following liver transplant in children

Management of post‐transplant lymphoproliferative disorder in adult solid organ transplant recipients – BCSH and BTS Guidelines

Malignancy in Renal Transplantation

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