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Related Experiment Videos

Update on primary central nervous system lymphoma.

Scott R Plotkin1

  • 1Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA. splotkin@partners.org

Current Opinion in Neurology
|November 11, 2005
PubMed
Summary

Primary central nervous system lymphoma (PCNSL) treatment is evolving, with methotrexate-based chemotherapy recommended for new cases. Optimal treatment, especially for recurrent PCNSL, remains undefined, highlighting the need for further research.

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Area of Science:

  • Neuro-oncology
  • Hematology
  • Lymphoma research

Background:

  • Primary central nervous system lymphoma (PCNSL) is a rare extranodal non-Hodgkin's lymphoma.
  • PCNSL is confined to the central nervous system and eye.
  • Recent advancements in pathology, imaging, and treatment have been published.

Purpose of the Study:

  • To review recent advances in understanding PCNSL pathology.
  • To discuss recent advances in radiographic appearance of PCNSL.
  • To review recent advances in treatment of PCNSL.

Main Methods:

  • Literature review of studies published in the past 2 years.
  • Discussion of novel treatment regimens for newly diagnosed and recurrent PCNSL.
  • Analysis of neurotoxicity associated with chemoradiation.

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Main Results:

  • Improved survival in PCNSL has revealed significant late neurotoxicity, particularly cognitive deficits from whole brain irradiation.
  • Standardization of phase II clinical trials is an ongoing goal, with proposed guidelines from the International Primary Central Nervous System Lymphoma Collaborative Group (IPCG).
  • Studies on uncommon histological variants of PCNSL have been published.

Conclusions:

  • The optimal treatment for PCNSL is not yet defined.
  • Methotrexate-based chemotherapy is recommended for newly diagnosed PCNSL, but the roles of irradiation and intrathecal chemotherapy require clarification.
  • Salvage therapy for recurrent or progressive PCNSL is under investigation, with no current standard recommendations.