Treatment, prognosis, and prophylaxis of secondary central nervous system lymphoma
- Andrew D Norden, MD
Andrew D Norden, MD
- Assistant Professor of Neurology
- Harvard Medical School
- Ephraim Hochberg, MD
Ephraim Hochberg, MD
- Assistant Professor of Medicine
- Harvard Medical School
- Fred H Hochberg, MD
Fred H Hochberg, MD
- Professor, Department of Neurology
- University of California at San Diego Moores Cancer Center
- Section Editors
- Arnold S Freedman, MD
Arnold S Freedman, MD
- Section Editor — Lymphoproliferative Disorders
- Professor of Medicine
- Harvard Medical School
- Patrick Y Wen, MD
Patrick Y Wen, MD
- Section Editor — Neurooncology
- Professor of Neurology
- Harvard Medical School
Systemic non-Hodgkin lymphoma (NHL) can involve the nervous system at every level, including peripheral nerve, spinal nerve roots, spinal cord, meninges, and brain; of these, leptomeningeal disease and brain involvement are most common. While central nervous system (CNS) disease must be managed to prevent neurologic morbidity and preserve quality of life, the survival of patients with secondary CNS lymphoma depends upon control of both CNS and systemic disease sites [1,2]. Thus, an effective treatment for secondary CNS lymphoma must address both compartments.
Treatment options for patients with secondary CNS lymphoma include:
●High-dose intravenous (IV) chemotherapy
●Intrathecal (IT) chemotherapy
●Radiation therapy to sites of radiographically apparent symptomatic disease
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- GENERAL APPROACH
- SYMPTOMATIC THERAPY
- SYSTEMIC CHEMOTHERAPY
- Is there a role for rituximab?
- High-dose chemotherapy with stem cell rescue
- INTRATHECAL THERAPY
- RADIATION THERAPY
- Who should receive prophylaxis?
- What prophylaxis should be used?
- SUMMARY AND RECOMMENDATIONS