Treatment of CNS lymphoma with the anti-CD20 antibody rituximab: Experience with two cases and review of the literature

Treatment with radio- and chemotherapy has become increasingly efficient in primary CNS lymphoma (PCNSL). However, time to tumor progression is often short, and the majority of patients eventually relapse. Therefore, new therapeutic modalities are needed. One possible new option is the use of monoclonal antibodies (moabs) such as the humanized anti-CD20 moab rituximab. Treatment with intravenous rituximab has resulted in response rates of 50% in systemic non-Hodgkin's lymphoma and was also efficient in PCNSL as well as in CNS involvement of systemic disease. However, rituximab concentrations in the cerebrospinal fluid are low after systemic application. Therefore, the authors performed an intraventricular rituximab treatment in 2 patients. The most recent results and the possible role of moabs in patients with PCNSL are summarized and discussed.