Journal of Neuro-Oncology

, Volume 103, Issue 3, pp 739–743

High-dose intravenous rituximab for multifocal, monomorphic primary central nervous system posttransplant lymphoproliferative disorder

  • A. Patrick
  • A. Wee
  • A. Hedderman
  • D. Wilson
  • J. Weiss
  • M. Govani
Case Report

Abstract

Primary central nervous system (CNS) posttransplant lymphoproliferative disorder (PTLD) is a well-recognized but rare complication of solid organ transplantation. Most of these disorders are B-cell in origin and generally carry poor prognosis. Rituximab, an anti-CD20 monoclonal antibody, has been used effectively in patients with systemic PTLD. However, its role in primary CNS PTLD is doubtful because it does not cross blood–brain barrier efficiently (<5%). Also, mechanisms, by which rituximab operates are not optimally effective in CNS. Here, we describe a renal transplant patient with monomorphic, multifocal, CD20-positive, primary B-cell CNS PTLD, who was treated with high-dose intravenous rituximab given in dose-escalation protocol, which has been used effectively for the patients with chronic lymphocytic leukemia. At 1-year follow-up, magnetic resonance imaging (MRI) showed complete resolution. High-dose rituximab may have a role in highly selected patients with primary CNS PTLD.

Keywords

Posttransplant lymphoproliferative disorder Primary CNS PTLD Rituximab Kidney transplantation 

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Copyright information

© Springer Science+Business Media, LLC. 2010

Authors and Affiliations

  • A. Patrick
    • 1
  • A. Wee
    • 2
  • A. Hedderman
    • 1
  • D. Wilson
    • 3
  • J. Weiss
    • 1
  • M. Govani
    • 4
  1. 1.Department of MedicineSt. Vincent HospitalIndianapolisUSA
  2. 2.Department of Kidney TransplantationSt. Vincent HospitalIndianapolisUSA
  3. 3.Department of PathologySt. Vincent HospitalIndianapolisUSA
  4. 4.Department of Medicine/NephrologySt. Vincent HospitalIndianapolisUSA

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