Management of histologically aggressive lymphomas with a high risk of CNS disease

The NHLs are a group of neoplasms that share a common target tissue, and are characterized by a high degree of biological and clinical heterogeneity. Adult lymphomas with a high propensity for CNS involvement comprise SNCC, lymphoma (ATLL), LL, and PCL of immunocompromised patients. Despite recently reported encouraging results, there is no standard therapy available for ATLL or PCL. In contrast, recent data from several groups suggest that the therapeutic outcome of SNCC lymphoma in adults is similar to the excellent results in children, when the same regimens are used, and the toxicity, at least for adults less than 60 years, is also similar. Although more intensive chemotherapy combined with CNS prophylaxis has extended the long-term survival of patients with LL, the treatment results in adults fall short of those for children.