Qian Liren, Tomuleasa Ciprian, Florian Ioan-Alexandru, Shen Jianliang, Florian Ioan-Stefan, Zdrenghea Mihnea, Dima Delia
Department of Hematology, Navy General Hospital of PLA, Beijing, China.
Department of Hematology, Iuliu Hatieganu University, Cluj Napoca, Romania.
Blood Res. 2017 Sep;52(3):159-166. doi: 10.5045/br.2017.52.3.159. Epub 2017 Sep 25.
Primary central nervous system lymphoma (PCNSL) is a type of highly invasive non-Hodgkin lymphoma. With a growing number of organ transplantation and immunosuppressant therapy, the incidence of PCNSL has been growing rapidly in recent years, which is attributed to the increased incidence of HIV/AIDS, a prominent risk factor for developing PCNSL. The rising rate of PCNSL incidence is the highest among the intracranial tumors. In the past 20 years, dozens of clinical trials related to PCNSL have been registered, but adequate therapeutics are still challenging. Currently, the chemotherapy regimens based on high-dose methotrexate and whole-brain radiotherapy are the two main therapeutic options; however, the toxicity associated with those is the main problem that challenges medical researchers. Novel agents and therapeutic strategies have been developed in recent years. In the current review, we describe advances in the treatment of PCNSL and discuss novel therapeutic approaches currently in development, such as the use of rituximab, disruption of the blood-brain barrier, and state-of-the-art radiotherapy.
原发性中枢神经系统淋巴瘤(PCNSL)是一种高度侵袭性的非霍奇金淋巴瘤。随着器官移植和免疫抑制治疗的增多,近年来PCNSL的发病率迅速上升,这归因于HIV/AIDS发病率的增加,HIV/AIDS是PCNSL发生的一个重要危险因素。PCNSL发病率的上升速度在颅内肿瘤中是最高的。在过去20年里,已经登记了几十项与PCNSL相关的临床试验,但找到充分的治疗方法仍然具有挑战性。目前,基于大剂量甲氨蝶呤和全脑放疗的化疗方案是两种主要的治疗选择;然而,与之相关的毒性是困扰医学研究人员的主要问题。近年来已经开发出了新型药物和治疗策略。在本综述中,我们描述了PCNSL治疗方面的进展,并讨论了目前正在研发的新型治疗方法,如利妥昔单抗的使用、血脑屏障的破坏以及最先进的放疗技术。