The possible role of maintenance treatment for primary central nervous system lymphoma

Blood Rev. 2018 Sep;32(5):378-386. doi: 10.1016/j.blre.2018.03.003. Epub 2018 Mar 11.

Abstract

Primary central nervous system lymphoma (PCNSL) is a rare and aggressive brain tumor. The prognosis is poor, with high rates of relapse and disease progression after treatment. In addition, PCNSL affects a largely older population, so that a significant proportion of patients are ineligible for intensive therapies and high-dose chemotherapy. The elderly patients are also susceptible to the accelerated and detrimental cognitive side effects of whole-brain irradiation which is an alternative consolidation to high-dose chemotherapy. Maintenance therapy has been shown to be a promising strategy to prolong remission time in other hematopoietic malignancies. Herein, we discuss the place of maintenance treatment in PCNSL in view of perspective obtained from hematological malignancies and non-Hodgkin's lymphoma.

Keywords: CNS lymphoma; Immune modulating therapy; Maintenance treatment; Metronomic therapy; Primary CNS lymphoma; Targeted therapy.

Publication types

  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Central Nervous System Neoplasms / diagnosis
  • Central Nervous System Neoplasms / therapy*
  • Clinical Decision-Making
  • Disease Management
  • Hematologic Neoplasms / diagnosis
  • Hematologic Neoplasms / therapy
  • Humans
  • Immunotherapy
  • Lymphoma, Non-Hodgkin / diagnosis
  • Lymphoma, Non-Hodgkin / therapy*
  • Maintenance Chemotherapy
  • Molecular Targeted Therapy