Diagnosis and management of primary central nervous system lymphoma: a consensus practice statement from the Australasian Lymphoma Alliance

Colm Keane; Nada Hamad; Allison Barraclough; Yoo Y Lee; Dipti Talaulikar; Matthew Ku; Joel Wight; Maciej Tatarczuch; Fiona Swain; Gareth P Gregory

doi:10.1111/imj.15658

Diagnosis and management of primary central nervous system lymphoma: a consensus practice statement from the Australasian Lymphoma Alliance

Intern Med J. 2022 Sep;52(9):1624-1632. doi: 10.1111/imj.15658. Epub 2022 Jul 27.

Authors

Colm Keane^{1

2}, Nada Hamad^{3

4

5}, Allison Barraclough⁶, Yoo Y Lee⁷, Dipti Talaulikar⁸, Matthew Ku^{9

10}, Joel Wight¹¹, Maciej Tatarczuch^{12

13}, Fiona Swain¹, Gareth P Gregory^{12

13}

Affiliations

¹ Division of Cancer Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
² Mater Research, University of Queensland, Brisbane, Queensland, Australia.
³ Department of Haematology, St Vincent's Hospital Sydney, Sydney, Australia.
⁴ School of Medicine, Sydney, University of Notre Dame Australia, Fremantle, Western Australia, Australia.
⁵ St Vincent's Clinical School, University of New South Wales, Sydney, Australia.
⁶ Department of Haematology, Fiona Stanley Hospital, Perth, Western Australia, Australia.
⁷ Radiation Oncology, Division of Cancer Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
⁸ Department of Haematology, Canberra Hospital, Canberra, Australian Capital Territory, Australia.
⁹ Department of Clinical Haematology, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.
¹⁰ Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.
¹¹ Department of Haematology, Townsville Hospital, Townsville, Queensland, Australia.
¹² Monash Haematology, Monash Health, Melbourne, Victoria, Australia.
¹³ School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.

PMID: 34927329
DOI: 10.1111/imj.15658

Abstract

Primary central nervous system lymphoma is a clinicopathological disease entity that accounts for 1% of all non-Hodgkin lymphoma (NHL). Advanced patient age, adverse disease biology and complexities of diagnosis and treatment render outcomes markedly inferior to systemic NHL. Despite this, an increasing evidence base, including limited randomised controlled clinical trial data, is informing optimal therapeutic strategies with methotrexate-based induction chemotherapy schedules and intensified consolidation in selected patients. This practice statement represents an evidence-based review of the literature and has been devised to assist healthcare professionals in the diagnosis and management of this disease.

Keywords: CNS; PCNSL; central nervous system; chemotherapy; lymphoma.

Publication types

Review

MeSH terms

Antineoplastic Combined Chemotherapy Protocols / therapeutic use
Central Nervous System
Central Nervous System Neoplasms* / drug therapy
Central Nervous System Neoplasms* / therapy
Consensus
Humans
Lymphoma* / diagnosis
Lymphoma* / therapy
Lymphoma, Non-Hodgkin* / diagnosis
Lymphoma, Non-Hodgkin* / therapy
Methotrexate / therapeutic use
Randomized Controlled Trials as Topic

Substances

Methotrexate