Intrathecal (IT) or intraventricular rituximab is effective and relatively safe in children with central nervous system (CNS) involvement of CD20+ B lymphoid malignancies, according to a study involving 25 children.
Participants received a total of 163 IT/intraventricular rituximab doses, with each getting a median of 6 doses and a median dosage of 25 mg. Among the results:
• Most common adverse events: grades 1 and 2 peripheral neuropathies in 5 patients, allergy in 2 patients, and headache in 2 patients.
• All occurred in the 48 hours after treatment and resolved within 24 hours.
• 3 patients had more severe though transient side effects: 1 had a grade III neuropathy and 2 had seizure.
• ~7 in every 10 patients receiving IT/intraventricular rituximab with or without other CNS-directed treatment experienced CNS remission.
Citation: Ceppi F, Weitzman S, Woessmann W, et al. Safety and efficacy of intrathecal rituximab in children with B cell lymphoid CD20+ malignancies: An international retrospective study. Am J Hematol. 2016;91(5):486-491. doi:10.1002/ajh.24329.