Two Cases of Treatment with Intrathecal Rituximab for Primary Central Nervous System Lymphoma

일차성 중추신경계 림프종의 경막 내 Rituximab 치료 2예

Primary central nervous system lymphoma (PCNSL) is an aggressive non-Hodgkin's lymphoma (NHL), usually composed of diffuse large B-cells. Although rituximab is known for its curative effect on B-cell NHL, data on the use of intrathecal rituximab for PCNSL are limited. In this report, we present two patients showing relapsed PCNSL with lymphomatous meningitis. Both patients were refractory to conventional methotrexate-based intrathecal chemotherapy. However, after intrathecal rituximab with or without conventional intrathecal chemotherapy, both patients showed stable disease on magnetic resonance brain imaging and cerebrospinal fluid analysis. There were no serious adverse events during each of 3 and 6 cycles with intrathecal rituximab immunotherapy.

일차성 중추 신경계 림프종(PCNSL)은 완전 관해 이후에도 재발이 흔하고 대부분 뇌연수막 전이에 의해 불량한 예후를 나타내는데 rituximab 경막 내 투여를 통해 PCNSL의 안정 병변 기간 연장 및 부작용은 거의 나타나지 않은 임상증례 2례를 경험하여 보고하며 rituximab 경막 내 투여에 대한 임상 시험 및 연구가 좀 더 필요할 수 있겠다.