Relapsed Primary Central Nervous System Lymphoma: Current Advances.

Area of Science:

• Neuro-oncology
• Hematology
• Immunology

Background:

• Primary central nervous system lymphoma (PCNSL) is a rare, aggressive malignancy. Complete response to first-line therapy is common, but high rates of relapse occur within two years.
• Relapsed PCNSL originates from occult lymphoma cells, with B cell receptor pathway activation and immune escape identified as key pathogenetic mechanisms.

Purpose of the Study:

• To provide a comprehensive overview of relapsed primary central nervous system lymphoma.
• To summarize current knowledge on the mechanisms, contributing factors, clinical manifestations, follow-up strategies, treatment options, and prognosis of relapsed PCNSL.

Main Methods:

• Literature review and synthesis of existing research on relapsed PCNSL.
• Analysis of pathogenetic mechanisms, clinical features, and treatment modalities.

Main Results:

• Relapses often occur within the central nervous system, but isolated systemic relapses are also observed with early, variable symptoms.
• Current treatment options for relapsed PCNSL include chemotherapy, radiation, stem-cell transplantation, targeted therapy, and immunotherapy.
• Despite advances, the overall prognosis for relapsed PCNSL remains poor, influenced by multiple factors.

Conclusions:

• Relapsed PCNSL presents significant therapeutic challenges due to its aggressive nature and poor prognosis.
• Further research into pathogenetic mechanisms and novel therapeutic strategies is essential to improve outcomes for patients with relapsed PCNSL.