Induction of long-term remission of a relapsed childhood B-acute lymphoblastic leukemia with rituximab chimeric anti-CD20 monoclonal antibody and autologous stem cell transplantation.

Childhood B-cell neoplasms account for approximately 2% of childhood acute lymphoblastic leukemia (ALL). The short but intensive chemotherapy yields a currently 75% to 85% event-free survival. The prognosis for children with relapsed disease is considered to be dismal. We report a 12-year old boy diagnosed with B-cell ALL with central nervous system (CNS) involvement. He relapsed in the bone marrow immediately after primary chemotherapy. Rituximab as a single agent achieved a complete morphologic remission. After 4 treatments with rituximab an isolated CNS relapse occurred. CNS remission was reinduced with chemotherapy and the patient received an autologous transplant with rituximab for in vivo purging. He is currently in complete clinical and molecular remission for more than 1 year.