Meeting Report: Primary Central Nervous System Lymphoma: Standards Of Care And Future Perspectives

Herrlinger, Ulrich; Korfel, Agnieszka; Hebart, Holger; Schlegel, Uwe; Plaßwilm, Ludwig; Illerhaus, Gerald; Finke, Jürgen; Krüger, William; Montemurro, Michael; Wolf, Timo; Thiel, Eckhart; Bamberg, M.; Weller, Michael; Kanz, Lothar

doi:10.1159/000083374

Cited by 5 publications

(8 citation statements)

References 19 publications

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“…Por ello, se están llevando a cabo ensayos clínicos de regímenes de poliquimioterapia complementarios al metotrexate a altas dosis 33,34 (topotecan 35 , temozolamida, rituximab intratecal 36 ...) sin radioterapia para estos pacientes [37][38][39] . Para los pacientes menores de 60 años, el tratamiento de consolidación de elección sería la radioterapia holocraneal 39,40 , ya que el retraso del tratamiento radioterápico podría conllevar un peor control de la enfermedad en estos pacientes más jóvenes 32 . La dosis estándar de radiación holocraneal es de 45 Gy.…”

Section: Diagnóstico Y Tratamientounclassified

“…No se recomienda radiación profiláctica espinal, excepto en los raros casos de linfoma intramedular. Se ha descrito neurotoxicidad para dosis totales superiores a 36 Gy y dosis diarias fraccionadas superiores a 1,8 Gy 40 . Con todo las dosis suelen ser menores que para otros tumores cerebrales.…”

Section: Diagnóstico Y Tratamientounclassified

“…El tratamiento del PCNSL plantea numerosas controversias en la actualidad, tales como el papel de la radioterapia y de la quimioterapia intratecal, la dosis y el momento de administración de la radioterapia y la protocolización de distintas pautas de tratamiento en función de la edad del paciente. Para resolver éstas y otras cuestiones se precisa ahondar en el estudio del PCNSL y la realización de potentes ensayos clínicos 40,34…”

Section: Diagnóstico Y Tratamientounclassified

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Linfoma cerebral primario: revisión bibliográfica y experiencia en el Hospital de Navarra en los últimos 5 años (2000-2004)

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Gorosquieta

et al. 2005

Anales Sis San Navarra

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Primary cerebral lymphoma (Primary CNS Lymphoma, PCNSL) is an aggressive non-Hodgkin lymphoma that originates in the central nervous system without evidence of lymphoma in any other localization at the time of diagnosis. Primary cerebral lymphomas are less well-known and are characterized than their homologues the systemic lymphomas, as they are an entity whose frequency was scarce until a few decades ago. However, the great rise in incidence that this pathology has undergone over the last three decades, and which is still unexplained, makes more studies necessary to better understand the etiopathology of this entity. Thanks to the new systems of treatment, the prognosis of this pathology has improved significantly in recent years. Nonetheless, treatment of primary cerebral lymphoma continues to give rise to numerous controversies at present due to its high neurotoxicity in patients over 60 years of age, a group of patients frequently affected by this pathology. To resolve these and other questions it is necessary to deep in the study of primary cerebral lymphoma and to carry out high quality clinical trials.

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Section: Diagnóstico Y Tratamientounclassified

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Linfoma cerebral primario: revisión bibliográfica y experiencia en el Hospital de Navarra en los últimos 5 años (2000-2004)

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Llano

Gorosquieta

et al. 2005

Anales Sis San Navarra

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“…Systemic rituximab alone does not generally seem to be beneficial, but may be so only in selected patients [9,33]. In a small series with relapsed or progressive disease in HIV-negative persons, intrathecal rituximab was shown to be safe and partially effective [34-36] and therefore stands as a possible option.…”

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confidence: 99%

Treatment of HIV-related primary central nervous system lymphoma with azt high dose, HAART, interleukin-2 and foscarnet in three patients

et al. 2011

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PurposeCombined immunomodulatory and antiviral treatment was administered to three patients with newly diagnosed HIV-associated primary central nervous system lymphoma (PCNSL) in an attempt to improve outcomes.Patients and methodsThree patients from our institution who were recently diagnosed with HIV-associated PCNSL received intravenous azidothymidine (AZT) 1.6 gr. bid for two weeks, followed by oral AZT 250 mg bid from day 15. In addition, complementary highly active antiretroviral therapy (HAART) with a second nucleoside reverse transcriptase inhibitor (NRTI) plus one protease inhibitor (PI) and interleukin 2 (IL-2) subcutaneously 2 million units twice daily (bid) plus foscarnet 90 mg/kg bid were administered on days 1-14. One patient received anti-EpsteinBarr virus (EBV)-maintenance therapy with ganciclovir, followed by cidofovir [1].ResultsAll patients experienced progressive disease while on induction therapy, and switched early to whole-brain radiation therapy (WBRT) as second linetreatment. No grade 3 or 4 toxicities were observed. Two patients died on days 50 and 166 respectively due to progressive disease. The third patient with histologically proven lymphoproliferation and only suspected PCNSL remained alive at 53 months. He was on HAART and remained clinically and neurologically stable.ConclusionAlthough IL-2, HAART, high-dose AZT and foscarnet are used for other HIV-related conditions, they did not demonstrate benefit in lymphoma remission for 2 HIVassociated PCNSL patients. The third patient went into delayed remission after additional radiotherapy and was in good clinical and neurological health status over 53 months after diagnosis.

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“…To improve survival without increased toxicity, protocols including high‐dose therapy followed by autologous stem cell reinfusion after conventional chemotherapy used for induction of PCNSL and for mobilization of autologous blood stem cells have been investigated 2‐6 . The standard drug for induction therapy of PCNSL is methotrexate (MTX) in a dose of 8 to 12 g per m 2 7‐10 …”

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Mobilization of hemopoietic stem cells with high‐dose methotrexate plus granulocyte–colony‐stimulating factor in patients with primary central nervous system lymphoma

et al. 2008

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Meeting Report: Primary Central Nervous System Lymphoma: Standards Of Care And Future Perspectives

Cited by 5 publications

References 19 publications

Linfoma cerebral primario: revisión bibliográfica y experiencia en el Hospital de Navarra en los últimos 5 años (2000-2004)

Linfoma cerebral primario: revisión bibliográfica y experiencia en el Hospital de Navarra en los últimos 5 años (2000-2004)

Treatment of HIV-related primary central nervous system lymphoma with azt high dose, HAART, interleukin-2 and foscarnet in three patients

Mobilization of hemopoietic stem cells with high‐dose methotrexate plus granulocyte–colony‐stimulating factor in patients with primary central nervous system lymphoma

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