Rituximab, cyclophosphamide, vincristine, and prednisolone with high-dose methotrexate as an effective regimen in a frail patient with intravascular large B-cell lymphoma

Intravascular large B-cell lymphoma (IVLBCL) is a rare non-Hodgkin lymphoma characterized by the presence of lymphoma cells within the lumina of small vessels. Membranous CD20 is universally expressed on IVLBCL cells in immunohistochemical staining. The outcome of IVLBCL was dismal in the prerituximab era; however, rituximab in combination with chemotherapy has been proposed to be an effective treatment for IVLBCL. Herein, we report a 68-year-old female with “Asian variant” IVLBCL diagnosed from a pleural biopsy. We administered rituximab, cyclophosphamide, vincristine, and prednisolone (R-CVP) with high-dose methotrexate as the initial treatment. The patient achieved a complete response after the treatment. Therefore, R-CVP with high-dose methotrexate can be considered as a treatment option for frail IVLBCL patients.