Updates on primary central nervous system lymphoma Journal Article
| Authors: | Schaff, L. R.; Grommes, C. |
| Article Title: | Updates on primary central nervous system lymphoma |
| Abstract: | Purpose of Review: Primary central nervous system lymphoma (PCNSL) is an aggressive malignancy confined to the brain, spinal cord, leptomeninges, and eyes. Due to its rarity, there is a paucity of randomized trials and a varied approach to its management in the oncologic community. This review summarizes recent literature guiding current clinical practice. Recent Findings: The presentation, work up, and management of PCNSL are discussed. Induction therapy incorporates a methotrexate-based chemotherapy regimen and is generally followed by a consolidation regimen including high dose chemotherapy (with or without autologous stem cell rescue). Whole brain radiation therapy (WBRT) is a potential additional consolidation strategy. Management of relapsed and refractory disease poses a special challenge due to poor outcomes. Immunotherapy and targeted treatments are promising novel strategies for recurrent/refractory patients. Summary: Currently, there is little consensus in the management of PCNSL. Treatment recommendations should be tailored to the individual patient, with consideration for risk of neurotoxicity. New, exciting strategies are in development and when feasible, enrollment in a clinical trial should be considered. © 2018, Springer Science+Business Media, LLC, part of Springer Nature. |
| Keywords: | overall survival; lenalidomide; prednisone; review; hepatitis; doxorubicin; diarrhea; monotherapy; primary central nervous system lymphoma; treatment; cytarabine; methotrexate; rituximab; temozolomide; topotecan; cancer staging; drug megadose; neurotoxicity; nuclear magnetic resonance imaging; cancer incidence; cancer immunotherapy; progression free survival; computer assisted tomography; bone marrow suppression; etoposide; blood toxicity; nausea; vomiting; cyclophosphamide; dexamethasone; melphalan; vincristine; autologous stem cell transplantation; kidney failure; carmustine; ifosfamide; lomustine; procarbazine; thiotepa; temsirolimus; lumbar puncture; tumor recurrence; brain disease; headache; optimal drug dose; primary cns lymphoma; virus hepatitis; brain biopsy; pemetrexed; lung aspergillosis; stereotactic biopsy; leukoencephalopathy; teniposide; induction chemotherapy; whole brain radiotherapy; molecularly targeted therapy; intracranial hypertension; intraocular lymphoma; pcnsl; cancer prognosis; consolidation chemotherapy; nivolumab; infusion related reaction; ibrutinib; human; meprednisone; central nervous system aspergillosis |
| Journal Title: | Current Oncology Reports |
| Volume: | 20 |
| Issue: | 2 |
| ISSN: | 1523-3790 |
| Publisher: | Springer |
| Date Published: | 2018-02-01 |
| Start Page: | 11 |
| Language: | English |
| DOI: | 10.1007/s11912-018-0666-1 |
| PROVIDER: | scopus |
| PUBMED: | 29492682 |
| PMCID: | PMC6636316 |
| DOI/URL: | |
| Notes: | Review -- Export Date: 2 April 2018 -- Source: Scopus |
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