lymphoma survival | Principles for the treatment of primary central nervous system lymphomas in immunocompetent

Principles for the treatment of primary central nervous system lymphomas in immunocompetent

Summary
Interest in primitive central nervous system (LPSNC) lymphomas is related to the significant increase in incidence observed in both immunocompetent and immunocompromised and the progress made in recent years in the prognosis of These tumors. The reference treatment is based on the addition of intravenous high-dose methotrexate (MTX) chemotherapy (CT) to Brain radiation therapy (RT), allowing a median of survival of three to four years and a rate of long survivors of 30%. In elderly patients (> 60 years) who make up half of the patients, the RT of consolidation is no longer recommended if a complete remission is obtained with CT alone due to a high risk of leukoencephalopathy. The intensification of CT with peripheral stem cell graft constitutes a very promising therapeutic perspective in recurrences or, possibly, as an alternative to RT in the initial treatment.

Keywords
Lymphoma Central nervous system immunocompetent corticosteroids radiotherapy chemotherapy methotrexate neurotoxicity Primary central nervous system lymphoma
Abstract
Interest in primary CNS lymphoma (PCNSL) is growing because of its increasing incidence in both the immunocompetent and immunodeficient populations. The addition of high-dose methotrexate (MTX) based chemotherapy (CT) before whole brain radiotherapy (WBRT) has significantly improved the prognosis for PCNSL with a median survival rate of 3 – 4 years and about 30% of the patients having the possibility of lengthy Survival and cure. In the elderly (age > 60 years) CT alone (without RT) as initial treatment is recommended. This approach seems a good way of avoiding RT and thereby reducing the risk of delayed neurotoxicity. Intensive CT followed by hematopoietic stem cell Rescue (ICH) seems a promising approach for recurrent tumours and a potential alternative option to RT as consolidation treatment in newly diagnosed patients.

Keywords
Lymphoma Central Nervous system Immunocompetent steroids radiotherapy Chemotherapy Methotrexate neurotoxic