Aggressive Non-Hodgkin lymphomas: risk factors and treatment of central nervous system recurrence.

Abstract:

:Introduction: Secondary central nervous system lymphoma (SCNSL) is a potentially fatal event in the setting of aggressive Non-Hodgkin Lymphomas. Nowadays, despite of the very poor outcome of SCNSL, several studies are going to identify the high-risk patients' subgroup that could early develop this detrimental event and in whom the central nervous system (CNS) prophylaxis could improve survival. Areas covered: Herein, the authors will review the prophylactic and treatment strategy for SCNSL, focusing on the identification of high-risk subgroup. Expert opinion: The validated CNS International Prognostic Index score lacks sensitivity. The role of prophylaxis has been suggested as an important step for selected patients. Intrathecal prophylaxis is always less consolidated, due to its doubtful efficacy, whereas systemic high-dose methotrexate is becoming the favored option to reduce CNS relapse in high-risk aggressive lymphomas. However, there is no a clear guideline to help physicians in clinical practice. The encouraging results on treatment of primary CNS lymphoma prompted new therapeutic strategies for SCNSL, although larger and randomized prospective studies are needed. Future efforts should be addressed to better clarify these open questions.

journal_name

Expert Rev Hematol

authors

Santambrogio E,Nicolosi M,Vassallo F,Castellino A,Novo M,Chiappella A,Vitolo U

doi

10.1080/17474086.2019.1643232

subject

Has Abstract

pub_date

2019-09-01 00:00:00

pages

787-796

issue

9

eissn

1747-4086

issn

1747-4094

journal_volume

12

pub_type

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