Advances in the treatment of newly diagnosed primary central nervous system lymphomas

Abstract

Primary central nervous system lymphoma (PCNSL) is a type of highly invasive non-Hodgkin lymphoma. With a growing number of organ transplantation and immunosuppressant therapy, the incidence of PCNSL has been growing rapidly in recent years, which is attributed to the increased incidence of HIV/AIDS, a prominent risk factor for developing PCNSL. The rising rate of PCNSL incidence is the highest among the intracranial tumors. In the past 20 years, dozens of clinical trials related to PCNSL have been registered, but adequate therapeutics are still challenging. Currently, the chemotherapy regimens based on high-dose methotrexate and whole-brain radiotherapy are the two main therapeutic options; however, the toxicity associated with those is the main problem that challenges medical researchers. Novel agents and therapeutic strategies have been developed in recent years. In the current review, we describe advances in the treatment of PCNSL and discuss novel therapeutic approaches currently in development, such as the use of rituximab, disruption of the blood-brain barrier, and state-of-the-art radiotherapy.

Use of flow cytometry in the phenotypic diagnosis of hodgkin's lymphoma

“…In the last few years, various targeted drugs were investigated for HL, out of which the most promising results being shown by the anti‐CD30 antibody drug conjugate brentuximab vedotin and anti‐PD1 antibodies nivolumab and pembrolizumab . Single agent brentuximab vedotin was investigated as salvage therapy prior to and as consolidation treatment after high‐dose chemotherapy and autologous stem cell transplantation . In a single center phase II study conducted at the Memorial Sloan Kettering Cancer Center in New York, 45 patients with relapsed HL received each week brentuximab vedotin infusions at 1.2 mg/kg for two 4‐week cycles.…”

B Cells versus T Cells in the Tumor Microenvironment of Malignant Lymphomas. Are the Lymphocytes Playing the Roles of Muhammad Ali versus George Foreman in Zaire 1974?

“…They often have a variable clinical behavior. Some are indolent cell proliferations, whereas others have an aggressive behavior and a fulminant evolution [1][2][3][4][5]. T-cell lymphomas, in most cases, are classified into the second category, being aggressive tumors with increased resistance to treatment and more frequent and faster relapse rates when compared to B-cell lymphomas [6].…”

Clinical Approach to the Patient in Critical State Following Immunotherapy and/or Stem Cell Transplantation: Guideline for the On-Call Physician

“…An inappropriate approach with rushed clinical examination, over-burdened ward staff, and lack of medical training in recognizing impending organ failures are some of the reasons for delayed correct management [16]. Physical deterioration, with the most common premonitory signs being hypotension and a fall in the Glasgow Coma Scale/Score (GCS) (Table 1) [17,18,19,20], occurs over hours and if left unattended it impacts on patient morbidity and mortality [21,22]. Up to 25% of admissions or transfers to the ICU department from the ward have deteriorated to the point of cardiorespiratory arrest [23].…”