Interstitial pneumonitis during rituximab-containing chemotherapy for primary central nervous system lymphomas: a case report and review of literature

Background: Primary central nervous system lymphoma(PCNSL) is a rare kind of non-Hodgkin lymphoma. Rituximab combined with high-dose methotrexate, cytarabine and dexamethasone (R-MAD regimen) were reported effective for PCNSL patients. Rituximab can cause several side effects, including fever, chills and rigors. Case presentation: In this case report, we demonstrate rituximab-induced interstitial pneumonitis in a PCNSL patient who has been treated with R-MAD regimen. The patient recovered after treatment and she remains complete remission after following consolidation chemotherapy. Conclusions: Here is no report of potential fatal complications of Rituximab like interstitial pneumonitis nowadays in PCNSL patients. As Rituximab is widely used, physicians should raise their awareness of this rare complication and detect RTX-ILD in early stage.

Treatment of secondary central nervous system involvement in systemic aggressive B cell lymphoma using R-MIADD chemotherapy:a single-center study

Background:Secondary central nervous system lymphoma(SCNSL)is defined as lymphoma involvement within the central nervous system(CNS)that originated elsewhere,or a CNS relapse of systemic lymphoma.Prognosis of SCNSL is poor and the most appropriate treatment is still undetermined.Methods:We conducted a retrospective study to assess the feasibility of an R-MIADD(rituximab,high-dose methotrexate,ifosfamide,cytarabine,liposomal formulation of doxorubicin,and dexamethasone)regimen for SCNSL patients.Results:Nineteen patients with newly diagnosed CNS lesions were selected,with a median age of 58(range 20 to 72)years.Out of 19 patients,11(57.9%)achieved complete remission(CR)and 2(10.5%)achieved partial remission(PR);the overall response rate was 68.4%.The median progression-free survival after CNS involvement was 28.0 months(95%confidence interval 11.0–44.9),and the median overall survival after CNS involvement was 34.5 months.Treatment-related death occurred in one patient(5.3%).Conclusions:These single-centered data underscore the feasibility of an R-MIADD regimen as the induction therapy of SCNSL,further investigation is warranted.