Intralesional injection of rituximab and autologous serum as an alternative treatment for conjunctival lymphoma

Session Details

Session Title: Ocular Pathologies

Session Date/Time: Tuesday 08/09/2015 | 16:30-18:00

Paper Time: 17:08

Venue: Room 1

First Author: : S.de Manuel-Triantafilo SPAIN

Co Author(s): :    M. Matilla Rodero   M. Laura   M. Laura   O. Javier   I. Villarejo Diaz-Maroto   A. Alfonso     

Abstract Details

Purpose:

To present an alternative treatment for localised conjuntival MALT (mucous associated lymphoid tissue) lymphoma consisting on intralesional injection of rituximab, a chimeric monoclonal antibody that targets CD20 and to consider its association with autologous serum.

Setting:

Two patients from our clinic at Hospital Universitario Fundación Alcorcón of Madrid who were diagnosed with localised conjuntival MALT lymphoma and were followed-up for 2 years.

Methods:

Two patients, both men, aged 78 and 39 years presented with a visual acuity of 20/20, were asymptomatic and had a normal ophthalmological examination in exception of a salmon patch conjuntival lesion which was biopsied and revealed to be a MALT lymphoma. The extension examination proved that the lesion was confined to the conjunctiva and chlamydia psittacci serology was negative in both patients. They were treated however prophilactically with oral doxycicline. They were treated with 6 injections, once weekly, of rituximab associated with autologous serum.

Results:

The first patient did not show full response with this treatment , so radiotherapy was prescribed to persue complete remission obtaining good results and no recurrence after 2 years follow-up. Whereas the second patient showed a good response and almost complete remission of the lesion within 1 month and after 2 years follow-up there has been no need of further treatment.

Conclusions:

There are various treatment options to consider for conjuntival MALT lymphomas; local radiotherapy, systemic chemotherapy, surgery, alpha interferon or even observation. Rituximab is a chimeric monoclonal antibody which specifically binds to CD20 lymphocyte B antigens. Intralesional injection of rituximab is a selective therapy and its activity is enhanced by combining it with autologous serum with very few side effects described in the literature, and therefore avoiding the dreadful side effects of systemic treatment. Nonetheless, a longer follow-up of the patients to learn the duration of the response as well as its possible side effects in the long run is needed.

Financial Interest:

NONE