Chemotherapy is effective as early treatment for primary central nervous system lymphoma

Boiardi, A.; Silvani, Antonio; Pozzi, A.; Fariselli, Laura; Broggi, Giovanni; Salmaggi, Andrea

doi:10.1007/s004150050302

Cited by 24 publications

(3 citation statements)

References 38 publications

(83 reference statements)

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“…In some cases, reirradiation of relapsed lesions has also been indicated. In patients relapsed after chemotherapy as exclusive first-line treatment, some authors have suggested that chemotherapy is used again as salvage strategy [55,70]. The most used cytostatic in patients who have relapsed after high-dose methotrexate is cytarabine, but procarbazine, vincristine, cisplatin, temozolomide and several other drugs have also been used.…”

Section: Treatment Of Relapsed Patientsmentioning

confidence: 99%

Primary central nervous system lymphoma

Ferreri¹,

Reni²

2007

Critical Reviews in Oncology/Hematology

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Primary central nervous system lymphomas (PCNSL) are aggressive malignancies that arise in distinct anatomical sites, which display unique structural, biological and immunological conditions. So far, despite recent therapeutic advances, these malignancies exhibit one of the worst prognoses among all non-Hodgkin lymphomas (NHL). For a long time, radiotherapy (RT) has been the standard treatment, producing a response rate of 60-65% and a notable neurological improvement in most cases. However, relapse usually occurred within a few months after RT, with a median survival of 14 months and a 5-year survival of approximately 15-24%. Although the introduction of systemic chemotherapy has consistently improved survival, the prognosis of PCNSL is still dismal, with high rates of local relapse and consequent death. Defining the optimum therapeutic management is difficult because of potential selection biases in large retrospective reviews and the limited number of prospective studies. Although studies published on PCNSL are increasing, several therapeutic questions still remain unanswered after a decade of research.

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Section: Treatment Of Relapsed Patientsmentioning

confidence: 99%

Primary central nervous system lymphoma

Ferreri¹,

Reni²

2007

Critical Reviews in Oncology/Hematology

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“…The patient was treated with systemic chemotherapy consisting of methotrexate (with leucovorin), cyclophosphamide, doxorubicin, bleomycin, vincristine and dexamethasone [17]for three cycles, which achieved complete remission. Peripheral blood stem cells were mobilized with cyclophosphamide, cytarabine, etoposide, dexamethasone and subsequent granulocyte colony-stimulating factor (G-CSF) administration; a total of 32.7 × 10 6 CD34-positive cells/kg were harvested with apheresis.…”

Section: Case Reportmentioning

confidence: 99%

Very Late Central Nervous System Relapse in a Patient with B Cell Lymphoblastic Lymphoma

et al. 2004

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Very late relapse of lymphoblastic lymphoma (LBL) is very rare. We report a case of a patient who developed central nervous system (CNS) relapse of LBL 16 years after the onset of the primary disease. An 8-year-old girl was hospitalized with a skin tumor in the occipital region on November 27, 1984. Examination of a biopsy of the skin tumor showed typical features of non-Hodgkin’s lymphoma (diffuse medium-sized cell type). She received multiagent chemotherapy and went into remission. On July 4, 2000, she was hospitalized with persistent headache. Cranial magnetic resonance imaging showed a cerebellar lesion, which was hypointense on T1-weighted images and of heterogeneous intensity on T2-weighted images. A midline suboccipital craniotomy was performed and pathological examination revealed a diffuse proliferation of lymphoid cells, which were positive for terminal deoxynucleotidyl transferase, but negative for CD45RO, CD3 and CD20. Tumor cells stained positively for CD10, CD22, CD38 and HLA-DR. Revised immunohistochemistry of the primary specimens of skin tumor obtained 16 years earlier revealed a phenotype similar to that of the CNS disease. Polymerase chain reaction products for the immunoglobulin gene from both the skin and cerebellar specimens were an identical size. Thus, the original diagnosis of diffuse medium-sized lymphoma was revised to B cell LBL. An isolated CNS relapse of LBL was apparent in the present case. After salvage chemotherapy, the patient underwent high-dose chemotherapy with autologous peripheral blood stem cell support and subsequent craniospinal irradiation. She went into a lasting complete remission.

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“…After intravenous and intrathecal MTX and WBRT, approximately 30% of patients developed leukoencephalopathy 5, 6. This high rate of late side effects prompted trials testing high dose MTX alone7, 8 or in combination with other chemotherapy 9, 10. These studies showed response rates and prolongation of survival similar to combined modality treatment.…”

mentioning

confidence: 99%

Primary central nervous system lymphoma 1991-1997

Herrlinger

Schabet

Brugger

et al. 2001

Cancer

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BACKGROUND This retrospective single‐center study assesses the feasibility, therapeutic outcome, and late side effects of combined modality therapy with intravenous methotrexate, whole brain radiotherapy (WBRT), and intravenous cytarabine in patients with primary central nervous system lymphoma (PCNSL). METHODS All 28 consecutive patients diagnosed with PCNSL between 1991 and 1997 were scheduled to receive combined modality therapy. Seven of 28 patients did not receive combined modality treatment: 6 patients had WBRT alone because of poor physical condition, and 1 patient died before receiving treatment. Of the remaining 21 patients, 5 received the complete regimen, and 16 received a modified regimen with reduced dose intensity. RESULTS Fourteen of 21 patients (67%) treated with combined modality therapy had a complete response; 1 had a partial response. Median survival was 11 months in all 28 patients, 23 months in all patients with combined modality treatment, and 41 months in patients receiving the complete regimen. Of 15 examinable patients with a follow‐up of 8 months or more, 10 developed severely symptomatic and 5 mildly symptomatic or asymptomatic diffuse white matter changes. CONCLUSION Only a small subgroup of all patients with PCNSL appears to be eligible for receiving all parts of the combined modality regimen. Treatment in these patients leads to a marked prolongation of survival. The risk of late side effects is high even with modified, dose intensity–reduced versions of combined modality treatment. Cancer 2001;91:130–5. © 2001 American Cancer Society.

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Chemotherapy is effective as early treatment for primary central nervous system lymphoma

Cited by 24 publications

References 38 publications

Primary central nervous system lymphoma

Primary central nervous system lymphoma

Very Late Central Nervous System Relapse in a Patient with B Cell Lymphoblastic Lymphoma

Primary central nervous system lymphoma 1991-1997

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