Dana-Farber Cancer Institute, Boston, MA, USA; Brigham and Women's Hospital; Harvard Medical School.
Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Hematol Oncol Clin North Am. 2022 Feb;36(1):147-159. doi: 10.1016/j.hoc.2021.09.004.
Primary central nervous system lymphoma is a rare and aggressive extranodal non-Hodgkin lymphoma restricted to the brain, spinal cord, cerebrospinal fluid, and eyes. Optimization of treatment including high-dose methotrexate-based chemotherapy followed by consolidation therapy in the form of autologous stem cell transplant or whole-brain radiation leads to improved survival. However, several patients do not respond to upfront therapy and the relapse risk is high. Additionally, there is a risk of delayed neurotoxicity, particularly in older patients. Recent molecular insights underlying the pathophysiology of PCNSL have led to the development of clinical trials involving targeted therapies and immunotherapies for salvage.
原发性中枢神经系统淋巴瘤是一种罕见且侵袭性的结外非霍奇金淋巴瘤,仅局限于大脑、脊髓、脑脊液和眼睛。包括大剂量甲氨蝶呤为基础的化疗在内的治疗优化,随后进行自体干细胞移植或全脑放疗形式的巩固治疗,可提高生存率。然而,有部分患者对初始治疗无反应,且复发风险较高。此外,还存在迟发性神经毒性的风险,尤其是在老年患者中。PCNSL 病理生理学的最新分子研究进展导致了针对挽救性治疗的靶向治疗和免疫治疗的临床试验的开展。