Major Central Nervous System Lymphoma.
Semin Neurol. 2018 Feb;38(1):86-94
Authors: Löw S, Batchelor TT
Major central nervous system lymphoma (PCNSL) is an extranodal non-Hodgkin lymphoma restricted to the mind, spinal wire, leptomeninges, and eyes. The vast majority of sufferers are immunocompetent, with a median age of 65 years at prognosis. Traditionally, whole-brain radiation remedy (WBRT) was the primary and sole remedy for PCNSL. Right now, as a result of acknowledged neurotoxicity of WBRT, this modality is normally prevented within the remedy. Most chemotherapy regimens are based mostly on high-dose methotrexate plus the anti-CD20 monoclonal antibody rituximab, resulting in excessive response charges, however 5-year survival continues to be poor at roughly 30% in contrast with different extranodal lymphomas. New remedy methods together with high-dose chemotherapy/autologous stem cell transplantation, focused therapies specializing in, for instance, genetic alterations in B cells or mammalian goal of rapamycin signaling, and immunotherapy with inhibitors of the programmed cell dying 1 receptor are just a few choices to enhance the armamentarium in opposition to PCNSL.
PMID: 29548055 [PubMed – in process]