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Journal of Hematology & Oncology
Published in: Journal of Hematology & Oncology 1/2022

Open Access 01-12-2022 | Lymphoma | Review

Evidence-based expert consensus on the management of primary central nervous system lymphoma in China

Authors: Tong Chen, Yuanbo Liu, Yang Wang, Qing Chang, Jinsong Wu, Zhiliang Wang, Daoying Geng, Jin-Tai Yu, Yuan Li, Xiao-Qiu Li, Hong Chen, Dongxiao Zhuang, Jianyong Li, Bin Wang, Tao Jiang, Lanting Lyu, Yuqin Song, Xiaoguang Qiu, Wenbin Li, Song Lin, Xinghu Zhang, Dehong Lu, Junqiang Lei, Yaolong Chen, Ying Mao

Published in: Journal of Hematology & Oncology | Issue 1/2022

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Abstract

Primary central nervous system lymphoma (PCNSL) is a type of central nervous system restricted non-Hodgkin lymphoma, whose histopathological diagnosis is majorly large B cell lymphoma. To provide specific, evidence-based recommendations for medical professionals and to promote more standardized, effective and safe treatment for patients with PCNSL, a panel of experts from the Chinese Neurosurgical Society of the Chinese Medical Association and the Society of Hematological Malignancies of the Chinese Anti-Cancer Association jointly developed an evidence-based consensus. After comprehensively searching literature and conducting systematic reviews, two rounds of Delphi were conducted to reach consensus on the recommendations as follows: The histopathological specimens of PCNSL patients should be obtained as safely and comprehensively as possible by multimodal tomography-guided biopsy or minimally invasive surgery. Corticosteroids should be withdrawn from, or not be administered to, patients with suspected PCNSL before biopsy if the patient’s status permits. MRI (enhanced and DWI) should be performed for diagnosing and evaluating PCNSL patients where whole-body PET-CT be used at necessary time points. Mini-mental status examination can be used to assess cognitive function in the clinical management. Newly diagnosed PCNSL patients should be treated with combined high-dose methotrexate-based regimen and can be treated with a rituximab-inclusive regimen at induction therapy. Autologous stem cell transplantation can be used as a consolidation therapy. Refractory or relapsed PCNSL patients can be treated with ibrutinib with or without high-dose chemotherapy as re-induction therapy. Stereotactic radiosurgery can be used for PCNSL patients with a limited recurrent lesion who were refractory to chemotherapy and have previously received whole-brain radiotherapy. Patients with suspected primary vitreoretinal lymphoma (PVRL) should be diagnosed by vitreous biopsy. PVRL or PCNSL patients with concurrent VRL can be treated with combined systemic and local therapy.
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Metadata
Title
Evidence-based expert consensus on the management of primary central nervous system lymphoma in China
Authors
Tong Chen
Yuanbo Liu
Yang Wang
Qing Chang
Jinsong Wu
Zhiliang Wang
Daoying Geng
Jin-Tai Yu
Yuan Li
Xiao-Qiu Li
Hong Chen
Dongxiao Zhuang
Jianyong Li
Bin Wang
Tao Jiang
Lanting Lyu
Yuqin Song
Xiaoguang Qiu
Wenbin Li
Song Lin
Xinghu Zhang
Dehong Lu
Junqiang Lei
Yaolong Chen
Ying Mao
Publication date
01-12-2022
Publisher
BioMed Central
Published in
Journal of Hematology & Oncology / Issue 1/2022
Electronic ISSN: 1756-8722
DOI
https://doi.org/10.1186/s13045-022-01356-7

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