Lymphomatoid Granulomatosis Medication

Updated: Dec 31, 2015
  • Author: Nader Kamangar, MD, FACP, FCCP, FCCM; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Medication

Medication Summary

No well-studied effective treatment exists for this disease. Apart from immunosuppressive regimens, experimental therapeutic options include interferon alfa-2b and ganciclovir.

  • Interferon alfa-2b
    • The association with EBV and posttransplant lymphoma prompted a group to treat lymphomatoid granulomatosis with interferon alfa-2b. [9]
    • This drug has antiviral, antiproliferative, and immunomodulatory effects.
    • All 4 patients who were treated responded, with 3 patients achieving a complete response at 3 months.
    • Most patients responded to a dosage of 10 million units administered subcutaneously 3 times a week.
    • At follow-up of 36-60 months, 3 patients remained disease-free.
  • Ganciclovir
    • A patient with lymphomatoid granulomatosis and positive EBV serology post–stem cell transplant for multiple myeloma was reported to have complete radiologic remission following 2 weeks of ganciclovir therapy.
    • It should be noted that immune reconstitution also coincided with recovery.
  • Rituximab [10, 11, 12, 13]
    • Rituximab is a monoclonal antibody that targets the B-cell surface molecule CD20. Several case reports of the efficacy of monoclonal antibodies have been published. [14, 15, 16] These case reports have involved patients with advanced disease refractory to other medical therapies. [17, 18]
    • Although some of these case reports appear promising, larger studies are needed to substantiate the efficacy of rituximab in the treatment of lymphomatoid granulomatosis.