Recurrent lymphomatous meningitis treated with intra-CSF rituximab and liposomal ara-C
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Background The most frequent central nervous system complication of systemic non-Hodgkin’s lymphoma (NHL) is lymphomatous meningitis (LM). Objective A clinical series to test the feasibility of combining intra-CSF liposomal ara-C and rituximab for the treatment of recurrent LM. Design Clinical series of 14 patients with CSF positive lymphomatous meningitis. Setting Tertiary-care university medical center. Results Fourteen patients with recurrent, cytologically positive lymphomatous meningitis were treated. All 14 received liposomal ara-C and rituximab utilizing an Ommaya reservoir. Six patients also received involved-field radiotherapy (brain only two patients; brain and spine two patients; spine only two patients). Best response to treatment included 10 partial responses and four with progressive disease. Estimated median duration of response was 4.0 months (range 1–6 months). Survival ranged from 1.5 to 7 months with an estimated median of 5 months, four patients remain alive and continue to be followed. Cause of death was progressive neurological disease in 7, systemic disease in 1, and combined systemic and neurological disease in 2 patients. Conclusions The combination of intra-CSF liposomal ara-C and rituximab administered in this schedule appears to have no additive toxicity and has modest palliative activity in patients with recurrent LM.
KeywordsLymphomatous meningitis Intra-CSF liposomal ara-C and rituximab
- 2.Haioun C, Besson C, Lepage E et al (2000) Incidence and risk factors of central nervous system relapse in histologically aggressive non-Hodgkin’s lymphoma uniformly treated and receiving intrathecal central nervous system prophylaxis: a GELA study on 974 patients. Groupe d’Etudes des Lymphomes de l’Adulte. Ann Oncol 11:685–690PubMedCrossRefGoogle Scholar
- 8.Hitchens R, Bell D, Woods R et al (1987) A prospective randomized trial of single-agent versus combination chemotherapy in meningeal carcinomatosis. J Clin Oncol 5:1655–1662Google Scholar
- 19.Maria BL, Boss TF, Guzman GA, Gouveia WA, White CA, Strauss MJ (1996) Cost of treating leptomeningeal metastases with intrathecal DepofoamTM encapsulated cytarabine. Presented at 1996 American society of clinical oncologists annual meeting, 18–21 May 1996, Philadelphia, Pennsylvania. Proc Am Soc Clin Oncol 15:160 (abstract 305)Google Scholar