2014
DOI: 10.1097/wco.0000000000000145
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Challenges in the treatment of elderly patients with primary central nervous system lymphoma

Abstract: PURPOSE OF REVIEW: Approximately 50% of all patients with primary central nervous system lymphoma (PCNSL) are 60 years or older and may therefore be considered as elderly. Although the diagnostic work-up is basically the same in young and in elderly patients, therapeutic strategies vary considerably. Here, we review the characteristics of elderly PCNSL patients with a particular focus on advances in the optimization of treatment regimens. RECENT FINDINGS: Age has been repeatedly confirmed as a major therapy-in… Show more

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Cited by 29 publications
(18 citation statements)
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“…Management of primary central nervous system (CNS) lymphoma (PCNSL) in patients aged ≥70 years represents a significant problem (Welch et al , ; Roth & Hoang‐Xuan, ; Mendez et al , ). While older PCNSL patients generally can tolerate and benefit from high‐dose methotrexate‐based induction, whole brain irradiation consolidation is not favoured because of excessive neurotoxicity.…”
Section: Characteristics Of Elderly Pcnsl Patients Who Received Low‐dmentioning
confidence: 99%
“…Management of primary central nervous system (CNS) lymphoma (PCNSL) in patients aged ≥70 years represents a significant problem (Welch et al , ; Roth & Hoang‐Xuan, ; Mendez et al , ). While older PCNSL patients generally can tolerate and benefit from high‐dose methotrexate‐based induction, whole brain irradiation consolidation is not favoured because of excessive neurotoxicity.…”
Section: Characteristics Of Elderly Pcnsl Patients Who Received Low‐dmentioning
confidence: 99%
“…However, their treatment remains challenging, as older age exposes the patients to a high risk of treatment-induced toxicity, especially radiation-related leukoencephalopathy and life-threatening systemic toxicities induced by intensive chemotherapy regimens [1][2][3][4]. Hence, there is a large consensus to recommend high-dose methothexate (MTX)-based polychemotherapy, without radiotherapy, as first line treatment in this vulnerable population [4][5][6].…”
Section: Introductionmentioning
confidence: 99%
“…Prospective outcome data for PCNSL patients above 65 years are limited, 4 yet older patients remain underrepresented in clinical trials. Comorbidities, poor baseline performance status and drug toxicity compromise outcomes in these patients 10‐12 …”
mentioning
confidence: 99%