Therapeutic challenges in primary CNS lymphoma

  title={Therapeutic challenges in primary CNS lymphoma},
  author={Patrick G Morris and Lauren E. Abrey},
  journal={The Lancet Neurology},

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Advances in Primary CNS Lymphoma: Randomized Clinical Trials of Chemotherapy and Whole-Brain Radiotherapy

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Although it may seem obvious from the successful management of systemic non-Hodgkin’s lymphoma (NHL) that a strategic multi-agent approach is optimal this question has never been directly studied in PCNSL.

Review: Chemotherapy in newly diagnosed primary central nervous system lymphoma

Different chemotherapeutic approaches for immunocompetent patients with newly diagnosed PCNSL are focused on and the role of local drug delivery in addition to systemic therapy is discussed, addressing the neurocognitive toxicity of treatment.

Ocular relapse of primary brain lymphoma in immunocompetent patient, treated with intrathecal rituximab

At a systemic level, alongside chemotherapy, its results are very modest and limited due to the low concentration it reaches in cerebrospinal fluid (CSF), however, its intrathecal and intraventricular use, though only isolated cases have been reported, has provided promising results.

Treatment approaches for primary CNS lymphomas

How the paradigm for PCNSL treatment changed during the 1990s from radiotherapy alone to the establishment of high-dose methotrexate–cytarabine combination as standard approach is illustrated.

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The treatment of patients with CNS lymphoma has posed a challenge since this entity was first described and it is important to define the histological subtypes of lymphoma involving the CNS since multiple histologies are known to occur in the CNS and the treatment can vary depending on the histology.

Primary CNS lymphoma in immunocompetent patients.

Future efforts should focus on the development of new polychemotherapy regimens allowing the reduction or deferral of WBRT in order to minimize the risk for delayed neurotoxicity.

How I treat patients with aggressive lymphoma at high risk of CNS relapse.

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The results indicate that rituximab might be efficacious in the treatment of PCNSL and support addition of this drug to current treatment protocols until data from randomized controlled trials becomes available.

A prospective phase II trial of response adapted whole brain radiotherapy after high dose methotrexate based chemotherapy in patients with newly diagnosed primary central nervous system lymphoma-analysis of acute toxicity profile and early clinical outcome

In patients with PCNSL, reduced dose WBRT after CR to HDMTX based chemotherapy may lead to suboptimal clinical outcome due to higher risk of recurrence, progression and early death.



Treatment of CNS Lymphoma with the Anti-CD20 Antibody Rituximab: Experience with Two Cases and Review of the Literature

Treatment with intravenous rituximab has resulted in response rates of 50% in systemic non-Hodgkin’s lymphoma and was also efficient in PCNSL as well as in CNS involvement of systemic disease, however, ritUXimab concentrations in the cerebrospinal fluid are low after systemic application.

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Treatment for primary CNS lymphoma: the next step.

Increasing the dose of MTX and adding procarbazine and vincristine improved disease control and overall survival in patients with newly diagnosed PCNSL and younger patients in particular fared extremely well with this treatment regimen.

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A retrospective study was conducted to assess the impact of consolidation treatment after a CR to initial induction chemotherapy on disease control and survival in patients with primary central nervous system lymphoma.

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