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Semin Neurol 2010; 30(3): 263-272
DOI: 10.1055/s-0030-1255222
© Thieme Medical Publishers

Treatment and Prevention of Secondary CNS Lymphoma

S. Nagpal1 , M. J. Glantz2 , Lawrence Recht1
  • 1Department of Neurology, Stanford University Medical School, Stanford, California
  • 2Departments of Neurosurgery and Oncology, Pennsylvania State College of Medicine, Hershey, Pennsylvania
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Publication History

Publication Date:
24 June 2010 (online)

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ABSTRACT

Central nervous system (CNS) involvement in non-Hodgkin lymphoma is a serious, potentially preventable complication that can occur in 5 to 10% of patients. Its occurrence is directly correlated with pathologic aggressiveness and ranges from less than 3% in the indolent, less-aggressive histologies to as high as 50% in the very aggressive ones such as Burkitt lymphoma. Aggressive treatment once detected can improve neurologic outcome, but because it is often associated with contemporaneous systemic relapse, is rarely associated with long-term survival. Preventing its occurrence, therefore, remains an important goal of initial treatment. Despite there being some suggestive evidence that the addition of systemic rituximab and several intracerebrospinal fluid chemotherapy regimens may have decreased the incidence of CNS involvement, both optimal selection of those patients who should receive prophylaxis as well as the best prophylactic regimen remain active areas of investigation.

KEYWORDS

Secondary CNS lymphoma - non-Hodgkin lymphoma - cerebrospinal fluid - CNS prophylaxis

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Lawrence RechtM.D. 

Advanced Medicine Clinic, Room CC2221, Stanford University School of Medicine

875 Blake Wilbur Drive, Stanford, CA 94305

Email: LRecht@stanford.edu

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