The Korean Journal of Medicine

  • 제87권2호
  • /
  • Pages.224-228
  • /
  • 2014
  • /
  • 1738-9364(pISSN)
  • /
  • 2289-0769(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
권호 표지
DOI QR코드

DOI QR Code

일차성 중추신경계 림프종의 경막 내 Rituximab 치료 2예

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

  • 장용호 (인제대학교 의과대학 상계백병원 내과) ;
  • 하태환 (인제대학교 의과대학 상계백병원 내과) ;
  • 김덕희 (인제대학교 의과대학 상계백병원 내과) ;
  • 김성록 (인제대학교 의과대학 상계백병원 내과) ;
  • 유영진 (인제대학교 의과대학 상계백병원 내과) ;
  • 손병석 (인제대학교 의과대학 상계백병원 내과) ;
  • 이혜란 (인제대학교 의과대학 일산백병원 내과)
  • Jang, Yong Ho (Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Ha, Tae Hwan (Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Kim, Deok Hee (Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Kim, Sung Rok (Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Yuh, Young Jin (Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Sohn, Byeong Seok (Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Lee, Hye Ran (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine)
  • 투고 : 2013.08.12
  • 심사 : 2013.10.30
  • 발행 : 2014.08.01
⟨ 이전 논문 다음 논문 ⟩

초록

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.

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.

키워드

참고문헌

  1. Ferreri AJ. How I treat primary CNS lymphoma. Blood 2011;118:510-522. https://doi.org/10.1182/blood-2011-03-321349
  2. Batchelor T, Loeffler JS. Primary CNS lymphoma. J Clin Oncol 2006;24:1281-1288. https://doi.org/10.1200/JCO.2005.04.8819
  3. Dietlein M, Pels H, Schulz H, et al. Imaging of central nervous system lymphomas with iodine-123 labeled rituximab. Eur J Haematol 2005;74:348-352. https://doi.org/10.1111/j.1600-0609.2004.00401.x
  4. Ferreri AJ, Blay JY, Reni M, et al. Prognostic scoring system for primary CNS lymphomas: the International Extranodal Lymphoma Study Group experience. J Clin Oncol 2003;21:266-272. https://doi.org/10.1200/JCO.2003.09.139
  5. Rubenstein JL, Combs D, Rosenberg J, et al. Rituximab therapy for CNS lymphomas: targeting the leptomeningeal compartment. Blood 2003;101:466-468. https://doi.org/10.1182/blood-2002-06-1636
  6. Rubenstein JL, Rosenberg J, Damon L. High-dose methotrexate plus rituximab (anti-CD20) monoclonal antibody in the treatment of primary CNS lymphoma: Society for NeuroOncology Fourth Annual Meeting. 1999 [Abstract].
  7. Rubenstein JL, Li J, Chen L, et al. Multicenter phase 1 trial of intraventricular immunochemotherapy in recurrent CNS lymphoma. Blood 2013;121:745-751. https://doi.org/10.1182/blood-2012-07-440974
  8. Schulz H, Pels H, Schmidt-Wolf I, Zeelen U, Germing U, Engert A. Intraventricular treatment of relapsed central nervous system lymphoma with the anti-CD20 antibody rituximab. Haematologica 2004;89:753-754.
  9. Rubenstein JL, Fridlyand J, Abrey L, et al. Phase I study of intraventricular administration of rituximab in patients with recurrent CNS and intraocular lymphoma. J Clin Oncol 2007;25:1350-1356. https://doi.org/10.1200/JCO.2006.09.7311
  10. Hong SJ, Kim JS, Chang JH, et al. A successful treatment of relapsed primary CNS lymphoma patient with intraventricular rituximab followed by high-dose chemotherapy with autologous stem cell rescue. Yonsei Med J 2009;50:280-283. https://doi.org/10.3349/ymj.2009.50.2.280