A narrative review of consolidation strategies for young and fit patients with newly-diagnosed primary central nervous system lymphoma

Expert Rev Hematol. 2021 Dec 14. doi: 10.1080/17474086.2022.2018297. Online ahead of print.ABSTRACTINTRODUCTION: The modern treatment of patients with primary central nervous system lymphoma (PCNSL) consists of two phases: induction, currently represented by a high-dose-methotrexate-based polychemotherapy, and consolidation. The optimal consolidation therapy has not been defined yet, but several strategies, such as whole-brain radiotherapy (WBRT), high-dose chemotherapy supported by autologous stem cell transplantation (HDC/ASCT) or non-myeloablative chemotherapy, have been addressed in important randomized trials.AREAS COVERED: This review provides an overview of the current role of consolidation strategies in young and fit patients with newly-diagnosed PCNSL. Publications in English language, peer-reviewed, from high-quality international journals, edited from 2003 to 2021 were identified on PubMed.EXPERT OPINION: Consolidation treatment significantly improved outcomes of PCNSL. Radiotherapy had represented for years the only choice in the consolidation therapy, but large randomized trials have demonstrated that HDC/ASCT is equally effective and associated with lower neurotoxicity risk in patients younger than 65-70 years. Encouraging results have been obtained using reduced-dose WBRT, while a recent randomized trial failed to demonstrate that consolidation with non-myeloablative chemotherapy is more effective than HDC/ASCT in PCNSL patients. A personalized consolidation tr...
Source: Expert Review of Hematology - Category: Hematology Authors: Source Type: research