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

Aggressive Non-Hodgkin Lymphomas: risk factors and treatment of central nervous system recurrence. Expert Rev Hematol. 2019 Jul 15;: Authors: Santambrogio E, Nicolosi M, Vassallo F, Castellino A, Novo M, Chiappella A, Vitolo U 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 add...
Source: Expert Review of Hematology - Category: Hematology Tags: Expert Rev Hematol Source Type: research