CSF biomarkers in primary CNS lymphoma

Area of Science:

• Neuro-oncology
• Hematology
• Diagnostic Pathology

Background:

• Primary CNS lymphoma (PCNSL) is an aggressive non-Hodgkin lymphoma (NHL) affecting the central nervous system.
• While therapeutic advances have improved prognosis, early diagnosis remains critical for optimal patient management.
• Current diagnosis relies on invasive tissue biopsy, which can be challenging due to location, patient condition, or misleading responses to steroids.

Purpose of the Study:

• To review and summarize diagnostic and prognostic cerebrospinal fluid (CSF) biomarkers for PCNSL.
• To discuss the potential utility, limitations, and challenges associated with these CSF biomarkers.
• To highlight the need for complementary diagnostic tools in PCNSL management.

Main Methods:

• Literature review of studies investigating CSF biomarkers in PCNSL.
• Analysis of diagnostic and prognostic performance of various proposed biomarkers.
• Discussion of clinical scenarios where CSF biomarkers could aid diagnosis, including differentiating relapse from post-treatment effects.

Main Results:

• Several CSF biomarkers have been proposed for PCNSL diagnosis and prognosis.
• These biomarkers show potential but often have limitations in sensitivity, specificity, or standardization.
• The review synthesizes current evidence on the utility and drawbacks of these biomarkers.

Conclusions:

• CSF biomarkers represent a promising avenue for improving PCNSL diagnosis and monitoring.
• Further research and validation are needed to establish reliable CSF biomarkers for routine clinical use.
• Development of non-invasive or less invasive diagnostic tools is crucial for PCNSL management.