Kalka Justin M, Kravets Alexander M, Sokol Bartosz
Surgery, Poznan University of Medical Sciences, Poznan, POL.
Neurosurgery, Poznan University of Medical Sciences, Poznan, POL.
Cureus. 2024 Dec 3;16(12):e75022. doi: 10.7759/cureus.75022. eCollection 2024 Dec.
The present study reports a single-center experience conducted at Józef Struś Multispecialty City Hospital in Poznań, Poland, in diagnosing and treating two patients with primary central nervous system lymphoma (PCNSL), one immunocompetent and one immunodeficient (AIDS). PCNSL is an extremely rare neoplasm with a poor prognosis and non-specific treatment on the basis of immunocompetency. Standard treatment consists of high-dose methotrexate (HD-MTX) being the background of a multimodal therapy, including other chemotherapeutic agents with and without radiation. To our knowledge, no alteration in management exists in immunocompromised individuals and so patients are subject to standard treatment options. Differences in patient management due to immunocompetency may necessitate separate protocols. The immunocompetent patient followed a more typical course, while the immunodeficient patient required balancing lymphoma treatment with the risks of opportunistic infections and drug interactions. These cases underscore the importance of tailored therapeutic approaches based on immune competency, aiming to improve outcomes for PCNSL.
本研究报告了在波兰波兹南的约瑟夫·斯特鲁斯多专科医院进行的一项单中心经验,该经验涉及诊断和治疗两名原发性中枢神经系统淋巴瘤(PCNSL)患者,一名免疫功能正常,一名免疫缺陷(艾滋病患者)。PCNSL是一种极其罕见的肿瘤,预后较差,且根据免疫功能状况进行非特异性治疗。标准治疗包括以大剂量甲氨蝶呤(HD-MTX)为基础的多模式治疗,包括使用或不使用放疗的其他化疗药物。据我们所知,免疫功能低下个体的治疗管理没有改变,因此患者接受标准治疗方案。由于免疫功能状况导致的患者管理差异可能需要单独的方案。免疫功能正常的患者病程更为典型,而免疫缺陷患者则需要在淋巴瘤治疗与机会性感染风险和药物相互作用之间进行权衡。这些病例强调了基于免疫功能制定个性化治疗方法的重要性,旨在改善PCNSL的治疗效果。