Posters

Intralesional Rituximab in the treatment of bilateral conjunctival lymphoma mucosa-associated lymphoid tissue (MALT) type. Case report

Poster Details

First Author: C.Rodriguez Vidal SPAIN

Co Author(s):    L. Galletero Pandelo   L. Giralt Peret   I. Charcán Laskibar   R. Feijoo Lera   N. Martinez Alday        

Abstract Details

Purpose:

To describe the use and the favorable short-term results in a patient with bilateral conjunctival lymphoma MALT type treated with intralesional Rituximab as a compassionate therapy. Although the statistics show up to 47% of systematic complaint in case of bilaterality, the complementary tests (PET-TAC) were negative to our patient, so after an exhaustive review of the published literature, the comparative analysis cost-benefit in relation to other possible treatments and taking into account its high safety profile and low toxicity, it is decided to carry out a compassionate therapy with intralesional injections of Rituximab, with the positive results described.

Setting:

Cruces University Hospital, Barakaldo, Bilbao, Spain.

Methods:

Our patient shows redness and discomfort of the ocular surface in her left eye, along with bilateral mucous secretion. The slit-lamp examination of the left eye reveals a raised salmon-pink lesion in the inferior fornix and a discrete follicular reaction in the right eye, with absence of systemic involvement. Given the high suspicion of lymphomatous lesion, a bilateral conjunctival sample is taken, where it is reported as a B-lymphoproliferative process, compatible with MALT-type lymphoma. Subsequently, a conjunctival excision-biopsy is performed, which confirms the diagnosis and provides a positive immunohistochemical profile for CD20 and CD43, so intralesional injections Rituximab are initiated.

Results:

The results obtained using intralesional Rituximab as compassionate therapy are satisfactory throughout the short-term follow-up: no signs of recurrence of the disease in conjunctiva and ocular surface discomfort are observed as well as mucosal secretion have disappeared, as observed in the registration of images taken over time. Periodic follow-up was carried out assessing visual acuity, the state of the ocular surface and controls of the possible systemic complaint, the patient has remained stable, asymptomatic and with good visions since then.

Conclusions:

Intralesional Rituximab is a well-tolerated and effective therapeutic option for treating extranodal CD20 + lymphomas, even in patients initially refractory to intravenous immunotherapy with Rituximab. Due to its good tolerance and low hematological toxicity, intralesional Rituximab is a safe and efficient option compared to other treatment lines such as Interferon alfa-2b. With this case, we support the previously published results about this monoclonal antibody and affirm that more studies are needed on the efficacy, indications and side effects of intralesional Rituximab treatment for patients with MALT conjunctival lymphoma.

Financial Disclosure:

None