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Open Access 01-09-2014 | Lymphomas (C Dearden, Section Editor)

Primary CNS Lymphoma

Authors: Elizabeth H. Phillips, Christopher P. Fox, Kate Cwynarski

Published in: Current Hematologic Malignancy Reports | Issue 3/2014

Abstract

Primary diffuse large B-cell lymphoma (DLBCL) of the central nervous system is an aggressive malignancy that exhibits unique biological features and characteristic clinical behaviour, with overall long-term survival rates of around 20–40 %. Clinical outcome has improved following the advent of chemoradiation protocols incorporating high-dose methotrexate in the mid-1980s, but disease relapse and adverse neurocognitive sequelae remain major clinical challenges. To address this, investigators have focused on improving drug therapy with novel cytotoxic combinations, monoclonal antibody therapy, and intensive chemotherapy consolidation approaches, in an attempt to improve disease control whilst reducing the requirement for whole-brain radiotherapy. Outcomes for patients that are older, immunocompromised, or have relapsed/refractory disease remain unsatisfactory and there is a paucity of clinical trial data to guide treatment of these groups. This review highlights recent advances in pathobiology, imaging, and clinical management of PCNSL and looks ahead to research priorities for this rare and challenging lymphoid malignancy.

Dolecek TA, Propp JM, Stroup NE, Kruchko C. CBTRUS statistical report: Primary brain and central nervous system tumors diagnosed in the United States in 2005–2009. Neuro Oncol. 2012;14.

Shiels MS, Pfeiffer RM, Hall HI, Li J, Goedert JJ, Morton LM, et al. Proportions of Kaposi sarcoma, selected non-Hodgkin lymphomas, and cervical cancer in the United States occurring in persons with AIDS, 1980–2007. JAMA. 2011;305:1450–9.PubMedPubMedCentral

Henry J, Heffner RJ, Dillard S, Earle K, Davis R. Primary malignant lymphomas of the central nervous system. Cancer. 1974;34:1293–302.PubMed

Bellinzona M, Roser F, Ostertag H, Gaab RM, Saini M. Surgical removal of primary central nervous system lymphomas (PCNSL) presenting as space occupying lesions: a series of 33 cases. Eur J Surg Oncol. 2005;31:100–5.PubMed

Weller M, Martus P, Roth P, Thiel E, Korfel A. Surgery for primary CNS lymphoma? Challenging a paradigm. Neuro Oncol. 2012;14:1481–4.PubMedPubMedCentral

6.•

Rubenstein JL, Wong VS, Kadoch C, Gao HX, Barajas R, Chen L, et al. CXCL13 plus interleukin 10 is highly specific for the diagnosis of CNS lymphoma. Blood. 2013;121:4740–8. Assessed CXCL13 and IL-10 as potential CSF biomarkers of PCNSL on a large cohort of patients. Findings were integrated with biological data demonstrating effects on chemotaxis and activation of potential downstream signalling pathways.PubMedPubMedCentral

Barajas RF, Rubenstein JL, Chang JS, Hwang J, Cha S. Diffusion-weighted MR imaging derived apparent diffusion coefficient is predictive of clinical outcome in primary central nervous system lymphoma. Am J Neuroradiol. 2010;31:60–6.PubMedPubMedCentral

Wieduwilt MJ, Valles F, Issa S, Behler CM, Hwang J, McDermott M, et al. Immunochemotherapy with intensive consolidation for primary CNS lymphoma: a pilot study and prognostic assessment by diffusion-weighted MRI. Clin Cancer Res. 2012;18:1146–55.PubMedPubMedCentral

Valles FE, Perez-Valles CL, Regalado S, Barajas RF, Rubenstein JL, Cha S. Combined diffusion and perfusion MR imaging as biomarkers of prognosis in immunocompetent patients with primary central nervous system lymphoma. AJNR Am J Neuroradiol. 2013;34:35–40.PubMedPubMedCentral

10.•

Morris PG, Correa DD, Yahalom J, Raizer JJ, Schiff D, Grant B, et al. Rituximab, methotrexate, procarbazine, and vincristine followed by consolidation reduced-dose whole-brain radiotherapy and cytarabine in newly diagnosed primary CNS lymphoma: final results and long-term outcome. J Clin Oncol. 2013;31:3971–9. Multi-centre prospective single-arm trial assessing the role of reduced-dose radiotherapy for patients in CR following induction chemotherapy, in an attempt to reduce late neurotoxic effects. Treatment-related and neurocognitive outcomes were encouraging.PubMed

11.

Mohile NA, Deangelis LM, Abrey LE. The utility of body FDG PET in staging primary central nervous system lymphoma. Neuro Oncol. 2008;10:223–8.PubMedPubMedCentral

12.

Kawai N, Miyake K, Yamamoto Y, Nishiyama Y, Tamiya T. 18F-FDG PET in the diagnosis and treatment of primary central nervous system lymphoma. Biomed Res Int. 2013;2013:247152.PubMedPubMedCentral

13.

Makino K, Hirai T, Nakamura H, Murakami R, Kitajima M, Shigematsu Y, et al. Does adding FDG-PET to MRI improve the differentiation between primary cerebral lymphoma and glioblastoma? Observer performance study. Ann Nucl Med. 2011;25:432–8.PubMed

14.

Kasenda B, Haug V, Schorb E, Fritsch K, Finke J, Mix M, et al. 18F-FDG PET is an independent outcome predictor in primary central nervous system lymphoma. J Nucl Med. 2013;54:184–91.PubMed

15.

Kawai N, Zhen H-N, Miyake K, Yamamaoto Y, Nishiyama Y, Tamiya T. Prognostic value of pretreatment 18F-FDG PET in patients with primary central nervous system lymphoma: SUV-based assessment. J Neurooncol. 2010;100:225–32.PubMed

16.

Ponzoni M, Issa S, Batchelor TT, Rubenstein JL. Beyond high-dose methotrexate and brain radiotherapy: novel targets and agents for primary CNS lymphoma. Ann Oncol. 2014;25:316–22.PubMed

17.

Tun HW, Personett D, Baskerville KA, Menke DM, Jaeckle KA, Kreinest P, et al. Pathway analysis of primary central nervous system lymphoma. Blood. 2008;111:3200–10.PubMedPubMedCentral

18.

Brunn A, Nagel I, Montesinos-Rongen M, Klapper W, Vater I, Paulus W, et al. Frequent triple-hit expression of MYC, BCL2, and BCL6 in primary lymphoma of the central nervous system and absence of a favorable MYC(low)BCL2 (low) subgroup may underlie the inferior prognosis as compared to systemic diffuse large B cell lymphom. Acta Neuropathol. 2013;126:603–5.PubMed

19.••

Rubenstein JL, Hsi ED, Johnson JL, Jung SH, Nakashima MO, Grant B, et al. Intensive chemotherapy and immunotherapy in patients with newly diagnosed primary CNS lymphoma: CALGB 50202 (Alliance 50202). J Clin Oncol. 2013;31:3061–8. Prospectively correlated biological data with outcomes. Provided evidence in a multi-centre single-arm trial that reasonable response rates and outcomes can be achieved with intensive consolidation chemotherapy, without subsequent WBRT or ASCT.PubMedPubMedCentral

20.

Cady FM, O’Neill BP, Law ME, Decker PA, Kurtz DM, Giannini C, et al. Del(6)(q22) and BCL6 rearrangements in primary CNS lymphoma are indicators of an aggressive clinical course. J Clin Oncol. 2008;26:4814–9.PubMedPubMedCentral

21.

Montesinos-Rongen M, Godlewska E, Brunn A, Wiestler OD, Siebert R, Deckert M. Activating L265P mutations of the MYD88 gene are common in primary central nervous system lymphoma. Acta Neuropathol. 2011;122:791–2.PubMed

22.

Braaten KM, Betensky RA, de Leval L, Okada Y, Hochberg FH, Louis DN, et al. BCL-6 expression predicts improved survival in patients with primary central nervous system lymphoma. Clin Cancer Res. 2003;9:1063–9.PubMed

23.

Levy O, DeAngelis LM, Filippa DA, Panageas KS, Abrey LE. Bcl-6 predicts improved prognosis in primary central nervous system lymphoma. Cancer. 2008;112:151–6.PubMed

24.

Gonzalez-Aguilar A, Idbaih A, Boisselier B, Habbita N, Rossetto M, Laurenge A, et al. Recurrent mutations of MYD88 and TBL1XR1 in primary central nervous system lymphomas. Clin Cancer Res. 2012;18:5203–11.PubMed

25.

Booman M, Szuhai K, Rosenwald A, Hartmann E, Kluin-Nelemans HC, De Jong D, et al. Genomic alterations and gene expression in primary diffuse large B-cell lymphomas of immune-privileged sites: the importance of apoptosis and immunomodulatory pathways. J Pathol. 2008;216:209–17.PubMed

26.

McPhail ER, Law ME, Decker PA, O’Neill BP. Influence of 6q22-23 on overall survival in primary central nervous system lymphoma. Analysis of North Central Cancer Treatment Group trials 86 72 52, 93 73 51 and 96 73 51. Br J Haematol. 2011;154:146–50.PubMedPubMedCentral

27.

Hayashi Y, Iwato M, Arakawa Y, Fujisawa H, Thoma Y, Hasegawa M, et al. Homozygous deletion of INK4a/ARF genes and overexpression of bcl-2 in relation with poor prognosis in immunocompetent patients with primary central nervous system lymphoma of the diffuse large B-cell type. J Neurooncol. 2001;55:51–8.PubMed

28.

Schwindt H, Vater I, Kreuz M, Montesinos-Rongen M, Brunn A, Richter J, et al. Chromosomal imbalances and partial uniparental disomies in primary central nervous system lymphoma. Leukemia. 2009;23:1875–84.PubMed

29.

Montesinos-Rongen M, Schmitz R, Brunn A, Gesk S, Richter J, Hong K, et al. Mutations of CARD11 but not TNFAIP3 may activate the NF-??B pathway in primary CNS lymphoma. Acta Neuropathol. 2010;120:529–35.PubMed

30.

Courts C, Montesinos-Rongen M, Brunn A, Bug S, Siemer D, Hans V, et al. Recurrent inactivation of the PRDM1 gene in primary central nervous system lymphoma. J Neuropathol Exp Neurol. 2008;67:720–7.PubMed

31.

Kraan W, Horlings HM, van Keimpema M, Schilder-Tol EJM, Oud MECM, Scheepstra C, et al. High prevalence of oncogenic MYD88 and CD79B mutations in diffuse large B-cell lymphomas presenting at immune-privileged sites. Blood Cancer J. 2013;3:e139.PubMedPubMedCentral

32.

Montesinos-Rongen M, Schafer E, Siebert R, Deckert M. Genes regulating the B cell receptor pathway are recurrently mutated in primary central nervous system lymphoma. Acta Neuropathol. 2012;124:905–6.PubMed

33.

Sung CO, Kim SC, Karnan S, Karube K, Shin HJ, Nam DH, et al. Genomic profiling combined with gene expression profiling in primary central nervous system lymphoma. Blood. 2011;117:1291–300.PubMed

34.

Joerger M, Huitema ADR, Illerhaus G, Ferreri AJM. Rational administration schedule for high-dose methotrexate in patients with primary central nervous system lymphoma. Leuk Lymphoma. 2012;53:1867–75.PubMed

35.

Ferreri AJM, Guerra E, Regazzi M, Pasini F, Ambrosetti A, Pivnik A, et al. Area under the curve of methotrexate and creatinine clearance are outcome-determining factors in primary CNS lymphomas. Br J Cancer. 2004;90:353–8.PubMedPubMedCentral

36.

Joerger M, Huitema ADR, Krähenbühl S, Schellens JHM, Cerny T, Reni M, et al. Methotrexate area under the curve is an important outcome predictor in patients with primary CNS lymphoma: a pharmacokinetic-pharmacodynamic analysis from the IELSG no. 20 trial. Br J Cancer. 2010;102:673–7.PubMedPubMedCentral

37.

Morris PG, Abrey LE, Reiner AS, Wu N, Panageas KS, Seko BS, et al. Methotrexate area under the curve as a prognostic factor in primary central nervous system lymphoma treated with immunochemoradiotherapy. Leuk Lymphoma. 2011;52:1891–7.PubMed

38.

Kasenda B, Rehberg M, Thürmann P, Franzem M, Veelken H, Fritsch K, et al. The prognostic value of serum methotrexate area under curve in elderly primary CNS lymphoma patients. Ann Hematol. 2012;91:1257–64.PubMed

39.

Joerger M, Ferreri AJM, Krähenbühl S, Schellens JHM, Cerny T, Zucca E, et al. Dosing algorithm to target a predefined AUC in patients with primary central nervous system lymphoma receiving high dose methotrexate. Br J Clin Pharmacol. 2012;73:240–7.PubMedPubMedCentral

40.

Chiusolo P, Giammarco S, Bellesi S, Metafuni E, Piccirillo N, De Ritis D, et al. The role of MTHFR and RFC1 polymorphisms on toxicity and outcome of adult patients with hematological malignancies treated with high-dose methotrexate followed by leucovorin rescue. Cancer Chemother Pharmacol. 2012;69:691–6.PubMed

41.

Radtke S, Zolk O, Renner B, Paulides M, Zimmermann M, Möricke A, et al. Germline genetic variations in methotrexate candidate genes are associated with pharmacokinetics, toxicity, and outcome in childhood acute lymphoblastic leukemia. Blood. 2013;121:5145–53.PubMed

42.

Hiraga S, Arita N, Ohnishi T, Kohmura E, Yamamoto K, Oku Y, et al. Rapid infusion of high-dose methotrexate resulting in enhanced penetration into cerebrospinal fluid and intensified tumor response in primary central nervous system lymphomas. J Neurosurg. 1999;91:221–30.PubMed

43.

Ferreri AJ, Reni M, Foppoli M, Martelli M, Pangalis GA, Frezzato M, et al. High-dose cytarabine plus high-dose methotrexate versus high-dose methotrexate alone in patients with primary CNS lymphoma: a randomised phase 2 trial. Lancet. 2009;374:1512–20.PubMed

44.

Ferreri AJM, Licata G, Foppoli M, Corazzelli G, Zucca E, Stelitano C, et al. Clinical relevance of the dose of cytarabine in the upfront treatment of primary CNS lymphomas with methotrexate-cytarabine combination. Oncologist. 2011;16:336–41.PubMedPubMedCentral

45.

Shah GD, Yahalom J, Correa DD, Lai RK, Raizer JJ, Schiff D, et al. Combined immunochemotherapy with reduced whole-brain radiotherapy for newly diagnosed primary CNS lymphoma. J Clin Oncol. 2007;25:4730–5.PubMed

46.

Batchelor TT, Grossman SA, Mikkelsen T, Ye X, Desideri S, Lesser GJ. Rituximab monotherapy for patients with recurrent primary CNS lymphoma. Neurology. 2011/03/09 ed. 2011;76:929–30.

47.

Fritsch K, Kasenda B, Hader C, Nikkhah G, Prinz M, Haug V, et al. Immunochemotherapy with rituximab, methotrexate, procarbazine, and lomustine for primary CNS lymphoma (PCNSL) in the elderly. Ann Oncol. 2011;22:2080–5.PubMed

48.

Birnbaum T, Stadler EA, Von Baumgarten L, Straube A. Rituximab significantly improves complete response rate in patients with primary CNS lymphoma. J Neurooncol. 2012;109:285–91.PubMed

49.

Gregory G, Arumugaswamy A, Leung T, Chan KL, Abikhair M, Tam C, et al. Rituximab is associated with improved survival for aggressive B cell CNS lymphoma. Neuro Oncol. 2013;15:1068–73.PubMedPubMedCentral

50.

Korfel A, Weller M, Martus P, Roth P, Klasen HA, Roeth A, et al. Prognostic impact of meningeal dissemination in primary CNS lymphoma (PCNSL): experience from the G-PCNSL-SG1 trial. Ann Oncol. 2012;23:2374–80.PubMed

51.

Khan RB, Shi W, Thaler HT, DeAngelis LM, Abrey LE. Is intrathecal methotrexate necessary in the treatment of primary CNS lymphoma? J Neurooncol. 2002;58:175–8.PubMed

52.

Taylor JW, Flanagan EP, O’Neill BP, Siegal T, Omuro A, DeAngelis L, et al. Primary leptomeningeal lymphoma: international primary CNS lymphoma collaborative group report. Neurology. 2013;81:1690–6.PubMed

53.

Glantz MJ, Cole BF, Recht L, Akerley W, Mills P, Saris S, et al. High-dose intravenous methotrexate for patients with nonleukemic leptomeningeal cancer: is intrathecal chemotherapy necessary? J Clin Oncol. 1998;16:1561–7.PubMed

54.

Pels H, Juergens A, Glasmacher A, Schulz H, Engert A, Linnebank M, et al. Early relapses in primary CNS lymphoma after response to polychemotherapy without intraventricular treatment: results of a phase II study. J Neurooncol. 2009;91:299–305.PubMed

55.

Sierra Del Rio M, Ricard D, Houillier C, Navarro S, Gonzalez-Aguilar A, Idbaih A, et al. Prophylactic intrathecal chemotherapy in primary CNS lymphoma. J Neurooncol. 2012;106:143–6.PubMed

56.

Ferreri AJM, Reni M, Pasini F, Calderoni A, Tirelli U, Pivnik A, et al. A multicenter study of treatment of primary CNS lymphoma. Neurology. 2002;58:1513–20.PubMed

57.•

Rubenstein JL, Li J, Chen L, Advani R, Drappatz J, Gerstner E, et al. Multicenter phase 1 trial of intraventricular immunochemotherapy in recurrent CNS lymphoma. Blood. 2013;121:745–51. Demonstrated the efficacy intraventricular rituximab in the relapse setting without systemic chemotherapy. Depending on the efficacy of intravenous rituximab in ongoing randomised trials, it may warrant re-evaluation of the role of intrathecal treatment in PCNSL.PubMedPubMedCentral

58.

Thiel E, Korfel A, Martus P, Kanz L, Griesinger F, Rauch M, et al. High-dose methotrexate with or without whole brain radiotherapy for primary CNS lymphoma (G-PCNSL-SG-1): a phase 3, randomised, non-inferiority trial. Lancet Oncol. 2010;11:1036–47.PubMed

59.•

Doolittle ND, Korfel A, Lubow MA, Schorb E, Schlegel U, Rogowski S, et al. Long-term cognitive function, neuroimaging, and quality of life in primary CNS lymphoma. Neurology. 2013;81:84–92. The most comprehensive formal assessment of long-term neurocognitive outcomes to date, comparing neurocognitive late effects in those receiving a variety of treatment modalities and demonstrating the extent of neurocognitive impairment throughout multiple domains attributable to WBRT.PubMedPubMedCentral

60.

Prica A, Chan K, Cheung MC. Combined modality therapy versus chemotherapy alone as an induction regimen for primary central nervous system lymphoma: a decision analysis. Br J Haematol. 2012;158:600–7.PubMed

61.

Bessell EM, López-Guillermo A, Villá S, Verger E, Nomdedeu B, Petit J, et al. Importance of radiotherapy in the outcome of patients with primary CNS lymphoma: an analysis of the CHOD/BVAM regimen followed by two different radiotherapy treatments. J Clin Oncol. 2002;20:231–6.PubMed

62.

Soussain C, Hoang-Xuan K, Taillandier L, Fourme E, Choquet S, Witz F, et al. Intensive chemotherapy followed by hematopoietic stem-cell rescue for refractory and recurrent primary CNS and intraocular lymphoma: Société Française de Greffe de Moëlle Osseuse-Thérapie Cellulaire. J Clin Oncol. 2008;26:2512–8.PubMed

63.

Illerhaus G, Marks R, Ihorst G, Guttenberger R, Ostertag C, Derigs G, et al. High-dose chemotherapy with autologous stem-cell transplantation and hyperfractionated radiotherapy as first-line treatment of primary CNS lymphoma. J Clin Oncol. 2006;24:3865–70.PubMed

64.•

Schorb E, Kasenda B, Atta J, Kaun S, Morgner A, Hess G, et al. Prognosis of patients with primary central nervous system lymphoma after high-dose chemotherapy followed by autologous stem cell transplantation. Haematologica. 2013;98:765–70. Largest retrospective study of first-line ASCT consolidation with long-term follow-up to date demonstrating very good long-term outcomes.PubMedPubMedCentral

65.

Kasenda B, Schorb E, Fritsch K, Finke J, Illerhaus G. Prognosis after high-dose chemotherapy followed by autologous stem-cell transplantation as first-line treatment in primary CNS lymphoma–a long-term follow-up study. Ann Oncol. 2012;23:2670–5.PubMed

66.

Soussain C, Choquet S, Fourme E, Delgadillo D, Bouabdallah K, Ghesquières H, et al. Intensive chemotherapy with thiotepa, busulfan and cyclophosphamide and hematopoietic stem cell rescue in relapsed or refractory primary central nervous system lymphoma and intraocular lymphoma: a retrospective study of 79 cases. Haematologica. 2012;97:1751–6.PubMedPubMedCentral

67.

Abrey LE, Moskowitz CH, Mason WP, Crump M, Stewart D, Forsyth P, et al. Intensive methotrexate and cytarabine followed by high-dose chemotherapy with autologous stem-cell rescue in patients with newly diagnosed primary CNS lymphoma: an intent-to-treat analysis. J Clin Oncol. 2003;21:4151–6.PubMed

68.

Omuro AMP, Chinot O, Taillandier L, Ghesquières H, Soussain C, Delwail V, et al. Multicenter randomized phase II trial of methotrexate (MTX) and temozolomide (TMZ) versus MTX, procarbazine, vincristine, and cytarabine for primary CNS lymphoma (PCNSL) in the elderly: an Anocef and Goelams Intergroup study. J Clin Oncol. 2013;31:2032.

69.

Kim YR, Kim SH, Chang JH, Suh CO, Kim SJ, Kim Y, et al. Early response to high-dose methotrexate, vincristine, and procarbazine chemotherapy-adapted strategy for primary CNS lymphoma: no consolidation therapy for patients achieving early complete response. Ann Hematol. 2014;93:211–9.PubMed

70.

Pentsova E, DeAngelis LM, Omuro A. Methotrexate re-challenge for recurrent primary central nervous system lymphoma. J Neurooncol. 2014;117:161–5.PubMed

71.

Mappa S, Marturano E, Licata G, Frezzato M, Frungillo N, Ilariucci F, et al. Salvage chemoimmunotherapy with rituximab, ifosfamide and etoposide (R-IE regimen) in patients with primary CNS lymphoma relapsed or refractory to high-dose methotrexate-based chemotherapy. Hematol Oncol. 2013;31:143–50.PubMed

72.

Nguyen PL, Chakravarti A, Finkelstein DM, Hochberg FH, Batchelor TT, Loeffler JS. Results of whole-brain radiation as salvage of methotrexate failure for immunocompetent patients with primary CNS lymphoma. J Clin Oncol. 2005;23:1507–13.PubMed

73.

Hottinger AF, Deangelis LM, Yahalom J, Abrey LE. Salvage whole brain radiotherapy for recurrent or refractory primary CNS lymphoma. Neurology. 2007;69:1178–82.PubMed

74.

Enting RH, Demopoulos A, DeAngelis LM, Abrey LE. Salvage therapy for primary CNS lymphoma with a combination of rituximab and temozolomide. Neurology. 2004;63:901–3.PubMed

75.

Makino K, Nakamura H, Hide TI, Kuratsu JI. Salvage treatment with temozolomide in refractory or relapsed primary central nervous system lymphoma and assessment of the MGMT status. J Neurooncol. 2012;106:155–60.PubMed

76.

Wong SF, Gan HK, Cher L. A single centre study of the treatment of relapsed primary central nervous system lymphoma (PCNSL) with single agent temozolomide. J Clin Neurosci. 2012;19:1501–5.PubMed

77.

Reni M, Zaja F, Mason W, Perry J, Mazza E, Spina M, et al. Temozolomide as salvage treatment in primary brain lymphomas. Br J Cancer. 2007;96:864–7.PubMedPubMedCentral

78.

Nayak L, Abrey LE, Drappatz J, Gilbert MR, Reardon DA, Wen PY, et al. Multicenter phase II study of rituximab and temozolomide in recurrent primary central nervous system lymphoma. Leuk Lymphoma. 2013;54:58–61.PubMed

79.

Raizer JJ, Rademaker A, Evens AM, Rice L, Schwartz M, Chandler JP, et al. Pemetrexed in the treatment of relapsed/refractory primary central nervous system lymphoma. Cancer. 2012;118:3743–8.PubMed

80.

Zhang J-P, Lee EQ, Nayak L, Doherty L, Kesari S, Muzikansky A, et al. Retrospective study of pemetrexed as salvage therapy for central nervous system lymphoma. J Neurooncol. 2013;115:71–7.PubMed

81.

Chamberlain MC. Salvage therapy with bendamustine for methotrexate refractory recurrent primary CNS lymphoma: a retrospective case series. J. Neurooncol. 2014;1–8.

82.

Fischer L, Thiel E, Klasen H, Birkmann J, Jahnke K, Martus P, et al. Prospective trial on topotecan salvage therapy in primary CNS lymphoma. Ann Oncol. 2006;17:1141–5.PubMed

83.

Bessell EM, Dickinson P, Dickinson S, Salmon J. Increasing age at diagnosis and worsening renal function in patients with primary central nervous system lymphoma. J Neurooncol. 2011;104:191–3.PubMed

84.

Shibamoto Y, Sumi M, Onodera S, Matsushita H, Sugie C, Tamaki Y, et al. Primary CNS lymphoma treated with radiotherapy in Japan: a survey of patients treated in 2005–2009 and a comparison with those treated in 1985–2004. Int J Clin Oncol. 2013;1–9.

85.

Panageas KS, Elkin EB, Ben-Porat L, DeAngelis LM, Abrey LE. Patterns of treatment in older adults with primary central nervous system lymphoma. Cancer. 2007;110:1338–44.PubMed

86.

Welch MR, Omuro A, Deangelis LM. Outcomes of the oldest patients with primary CNS lymphoma treated at Memorial Sloan-Kettering Cancer Center. Neuro Oncol. 2012;14:1304–11.PubMedPubMedCentral

87.

Roth P, Martus P, Kiewe P, Möhle R, Klasen H, Rauch M, et al. Outcome of elderly patients with primary CNS lymphoma in the G-PCNSL-SG-1 trial. Neurology. 2012;79:890–6.PubMed

88.

Abrey LE, DeAngelis LM, Yahalom J. Long-term survival in primary CNS lymphoma. J Clin Oncol. 1998;16:859–63.PubMed

89.

Schuurmans M, Bromberg JEC, Doorduijn J, Poortmans P, Taphoorn MJB, Seute T, et al. Primary central nervous system lymphoma in the elderly: a multicentre retrospective analysis. Br J Haematol. 2010;151:179–84.PubMed

90.

Illerhaus G, Marks R, Müller F, Ihorst G, Feuerhake F, Deckert M, et al. High-dose methotrexate combined with procarbazine and CCNU for primary CNS lymphoma in the elderly: results of a prospective pilot and phase II study. Ann Oncol. 2009;20:319–25.PubMed

91.

Uldrick TS, Pipkin S, Scheer S, Hessol NA. Factors associated with survival among patients with AIDS-related primary central nervous system lymphoma. AIDS. 2013;28:397–405.

92.

Bayraktar S, Bayraktar UD, Ramos JC, Stefanovic A, Lossos IS. Primary CNS lymphoma in HIV positive and negative patients: comparison of clinical characteristics, outcome and prognostic factors. J Neurooncol. 2011;101:257–65.PubMed

93.

Antinori A, De Rossi G, Ammassari A, Cingolani A, Murri R, Di Giuda D, et al. Value of combined approach with thallium-201 single-photon emission computed tomography and Epstein-Barr virus DNA polymerase chain reaction in CSF for the diagnosis of AIDS-related primary CNS lymphoma. J Clin Oncol. 1999;17:554–60.PubMed

94.

Yanagisawa K, Tanuma J, Hagiwara S, Gatanaga H, Kikuchi Y, Oka S. Epstein-barr viral load in cerebrospinal fluid as a diagnostic marker of central nervous system involvement of AIDS-related lymphoma. Intern Med. 2013;52:955–9.PubMed

95.

Barta SK, Xue X, Wang D, Tamari R, Lee JY, Mounier N, et al. Treatment factors affecting outcomes in HIV-associated non-Hodgkin lymphomas: a pooled analysis of 1546 patients. Blood. 2013;122:3251–62.PubMed

96.

Travi G, Ferreri AJM, Cinque P, Gerevini S, Ponzoni M, Terreni M, et al. Long-term remission of HIV-associated primary CNS lymphoma achieved with highly active antiretroviral therapy alone. Infection. 2012;30:119–21.

97.

González-Aguilar A, Soto-Hernández JL. The management of primary central nervous system lymphoma related to AIDS in the HAART era. Curr Opin Oncol. 2011;23:648–53.PubMed

98.

Nagai H, Odawara T, Ajisawa A, Hagiwara S, Watanabe T, Uehira T, et al. Whole brain radiation alone produces favourable outcomes for AIDS-related primary central nervous system lymphoma in the HAART era. Eur J Haematol. 2010;84:499–505.PubMed

99.

Wolf T, Kiderlen T, Atta J, Stephan C, Kann G, Brodt H, et al. Successful treatment of AIDS-associated, primary CNS lymphoma with rituximab- and methotrexate-based chemotherapy and autologous stem cell transplantation. Infection. 2014;42:445–7.PubMed

100.

Bohlius J, Schmidlin K, Costagliola D, Fätkenheuer G, May M, Caro Murillo AM, et al. Prognosis of HIV-associated non-Hodgkin lymphoma in patients starting combination antiretroviral therapy. AIDS. 2009;23:2029–37.PubMed

101.

Gopal S, Patel MR, Yanik EL, Cole SR, Achenbach CJ, Napravnik S, et al. Temporal trends in presentation and survival for HIV-associated lymphoma in the antiretroviral therapy era. J Natl Cancer Inst. 2013;105:1221–9.PubMedPubMedCentral

102.

Omuro AMP, Ben-Porat LS, Panageas KS, Kim AK, Correa DD, Yahalom J, et al. Delayed neurotoxicity in primary central nervous system lymphoma. Arch Neurol. 2005;62:1595–600.PubMed

103.

Correa DD, Maron L, Harder H, Klein M, Armstrong CL, Calabrese P, et al. Cognitive functions in primary central nervous system lymphoma: literature review and assessment guidelines. Ann Oncol. 2007;18:1145–51.PubMed

104.

Correa DD, Shi W, Abrey LE, Deangelis LM, Omuro AM, Deutsch MB, et al. Cognitive functions in primary CNS lymphoma after single or combined modality regimens. Neuro Oncol. 2012;14:101–8.PubMedPubMedCentral

105.•

Fossard G, Nicolas-Virelizier E, Rey P, Ducray F, Jouanneau E, Faurie P, et al. Utility of post therapy brain surveillance imaging in the detection of primary CNS lymphoma (PCNSL) relapse. Blood. 2013;122. Presented an important observation in a relatively large retrospective cohort that 80 % of PCNSL relapses occur in between surveillance scans, thus demonstrating very limited utility for routine post-therapy imaging.

106.

Nayak L, Hedvat C, Rosenblum MK, Abrey LE, De Angelis LM. Late relapse in primary central nervous system lymphoma: clonal persistence. Neuro Oncol. 2011;13:525–9.PubMedPubMedCentral

107.

Ferreri AJM, Ciceri F, Brandes AA, Montanari M, Balzarotti M, Spina M, et al. MATILDE chemotherapy regimen for primary CNS lymphoma: results at a median follow-up of 12 years. Neurology. 2014;82:1370–3.PubMed

Title: Primary CNS Lymphoma
Authors: Elizabeth H. Phillips
Christopher P. Fox
Kate Cwynarski
Publication date: 01-09-2014
Publisher: Springer US
Published in: Current Hematologic Malignancy Reports / Issue 3/2014
Print ISSN: 1558-8211
Electronic ISSN: 1558-822X
DOI: https://doi.org/10.1007/s11899-014-0217-2

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