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Progress in central nervous system lymphomas.

Chia-Ching Wang1, Julia Carnevale, James L Rubenstein

  • 1Division of Hematology/Oncology, Helen Diller Comprehensive Cancer Center University of California, San Francisco, CA, USA.

British Journal of Haematology
|May 20, 2014
PubMed
Summary
This summary is machine-generated.

Long-term survival is now achievable for primary central nervous system lymphoma (PCNSL) patients. Dose-intensive chemotherapy consolidation, particularly etoposide plus cytarabine (EA), improves progression-free survival without whole brain radiotherapy.

Keywords:
high-dose chemotherapyprimary CNS lymphomarituximabtumour microenvironment

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Area of Science:

  • Neuro-oncology
  • Hematology
  • Clinical Medicine

Background:

  • Primary central nervous system lymphoma (PCNSL) historically had a poor prognosis.
  • Recent advancements offer hope for long-term survival and potential cure in PCNSL patients.

Purpose of the Study:

  • To review current diagnostic, staging, and management principles for PCNSL.
  • To update knowledge on PCNSL pathogenesis and novel therapeutic strategies.

Main Methods:

  • Review of accumulated data from the past 10 years on PCNSL treatment.
  • Focus on dose-intensive chemotherapy consolidation regimens, specifically etoposide plus high-dose cytarabine (EA).
  • Analysis of induction regimens including methotrexate, temozolomide, and rituximab.

Main Results:

  • Long-term progression-free survival (PFS) is achievable in a significant fraction of PCNSL patients.
  • Dose-intensive chemotherapy consolidation, without whole brain radiotherapy, demonstrates reproducible promise.
  • The EA regimen in first complete remission shows efficacy.

Conclusions:

  • Evolving management principles and improved survival rates are evident in PCNSL.
  • Further progress in novel therapies is anticipated based on updated pathogenesis data.
  • PCNSL management is shifting towards more effective, less toxic consolidation strategies.