Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy.
Crit Rev Oncol Hematol. 2011 Aug;79(2):127-34. doi: 10.1016/j.critrevonc.2010.07.005. Epub 2010 Aug 8.
Central Nervous System (CNS) involvement in lymphoma can occur whether at diagnosis or, more often, at the progression or recurrence of disease and the most frequent clinical manifestation is lymphomatous meningitis (LM). The first risk factor for LM development is the histotype, with the highest incidence for highly aggressive non-Hodgkin's lymphomas (NHL) such as Burkitt's lymphoma (BL) and lymphoblastic lymphoma/acute lymphoblastic leukemia (LBL/ALL) and the lowest for indolent NHL. LM prophylaxis in aggressive NHL (other than BL and LBL/ALL) is a much debated question, because the identification of specific risk factors remains controversial. Moreover, there is not a consensus if the LM prophylaxis should consist of systemic chemotherapy (CT), intrathecal (i.t.) CT or both. In case of LM, the i.t. CT has a key role, but there is not a consensus on treatment schedule. Newer intensified regimens and rituximab lead to reconsider the whole approach to LM.
中枢神经系统（CNS）受累可发生于淋巴瘤诊断时，或更常见于疾病进展或复发时，最常见的临床表现为淋巴瘤性脑膜炎（LM）。LM 发生的第一个危险因素是组织学类型，高度侵袭性非霍奇金淋巴瘤（NHL）如伯基特淋巴瘤（BL）和淋巴母细胞淋巴瘤/急性淋巴细胞白血病（LBL/ALL）的发病率最高，惰性 NHL 的发病率最低。侵袭性 NHL（BL 和 LBL/ALL 除外）的 LM 预防是一个备受争议的问题，因为特定危险因素的识别仍存在争议。此外，如果 LM 预防应包括全身化疗（CT）、鞘内（i.t.）CT 或两者兼而有之，尚无共识。在发生 LM 的情况下，i.t. CT 具有关键作用，但关于治疗方案尚无共识。新型强化方案和利妥昔单抗促使人们重新考虑 LM 的整个治疗方法。
