Pharmacotherapy of primary CNS lymphoma Journal Article
| Authors: | Park, D. M.; Abrey, L. E. |
| Article Title: | Pharmacotherapy of primary CNS lymphoma |
| Abstract: | Primary CNS lymphoma (PCNSL) is distinguished from other brain tumours by its striking response to chemotherapy. Surgery has little role (if any) in the treatment of PCNSL. Radiation therapy has been proven to prolong survival but its use is complicated by delayed neurological toxicity, particularly among the elderly. Progress in understanding the physiology of the blood-brain barrier (BBB) and the pharmacology of chemotherapeutic agents has substantially improved the treatment and prognosis of this disease. The single most effective agent is methotrexate (MTX). The goal of delivering an adequate dose of MTX to the brain and the cerebrospinal fluid (CSF) has been achieved by a variety of strategies, including systemic high dose, intra-arterial injection following pharmacological disruption of the BBB and intrathecal (it.) administration. MTX-based combination chemotherapy has yielded the best results to date but the prognosis of patients with PCNSL remains significantly worse than comparable patients with systemic non-Hodgkin's lymphoma (NHL). Ongoing trials continue to test novel combinations of agents, doses and improved routes of delivery with the hope of improving disease control and diminishing treatment-related neurotoxicity. |
| Keywords: | controlled study; busulfan; prednisone; drug tolerability; review; doxorubicin; drug efficacy; gastrointestinal hemorrhage; chemotherapy; cytarabine; methotrexate; rituximab; temozolomide; topotecan; drug megadose; neurotoxicity; brain neoplasms; unindexed drug; bone marrow suppression; etoposide; antineoplastic combined chemotherapy protocols; peripheral neuropathy; cyclophosphamide; vincristine; drug potency; drug effect; lomustine; procarbazine; thiotepa; rash; drug distribution; drug mechanism; sulfonamide; folinic acid; lymphoma; drug infusion; drug clearance; corticosteroid derivative; methylprednisolone; seizure; vinca alkaloid; drug bioavailability; drug metabolism; drug absorption; antiretroviral therapy, highly active; drug half life; camptothecin derivative; dna topoisomerase inhibitor; primary cns lymphoma; psychosis; dihydrofolate reductase inhibitor; drug transport; lymphoma, aids-related; drug protein binding; phenytoin; brain edema; gyrase inhibitor; myopathy; cns; brain lymphoma; drug cerebrospinal fluid level; avascular necrosis; aseptic meningitis; focal epilepsy; chimeric antibody; paralytic ileus; aziridine derivative; tetrazine derivative; salicylic acid derivative; paraplegia; humans; human; male; female; methylhydrazine derivative |
| Journal Title: | Expert Opinion on Pharmacotherapy |
| Volume: | 3 |
| Issue: | 1 |
| ISSN: | 1465-6566 |
| Publisher: | Informa Healthcare |
| Date Published: | 2002-01-01 |
| Start Page: | 39 |
| End Page: | 49 |
| Language: | English |
| DOI: | 10.1517/14656566.3.1.39 |
| PUBMED: | 11772332 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 14 November 2014 -- Source: Scopus |
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