Successful long-term control of lymphomatous meningitis with intraventricular rituximab

Most primary central nervous system lymphomas (PCNSL) are highly malignant B-cell non-Hodgkin lymphomas. First-line therapy consists of high-dose methotrexate-based chemotherapy with or without whole brain radiotherapy. However, no standard of care is defined for refractory or recurrent PCNSL. We report a patient with lymphomatous meningitis, which was refractory to standard treatment but was successfully controlled for more than 6 years with intraventricular rituximab. Apart from two infections of the Ommaya reservoir, no severe side effects of intraventricular long-term treatment could be detected. This report indicates that intraventricular administration of rituximab might be beneficial in select patients with refractory or recurrent lymphomatous meningitis. (C) 2013 Elsevier Ltd. All rights reserved.