Advance on diagnosis and prophylaxis of central nervous system involvement in non-Hodgkin lymphoma / 白血病·淋巴瘤

ABSTRACT

Refractory central nervous system (CNS) lymphoma in patients with non-Hodgkin lymphoma (NHL) carries a poor prognosis, with a median survival of 2-6 months. CNS involvement in NHL is associated with young age, advanced stage, number of extranodal sites, elevated lactate dehydrogenase, and international prognostic index (IPI) score. The most promising treatment of autologous stem cell transplant can extend median survival from 10 to 26 months. CNS prophylaxis is required during the initial treatment of NHL subtypes that carry a high risk of CNS relapse, such as Burkitt lymphoma (BL), and lymphoblastic lymphoma.The use of CNS prophylaxis in the treatment of diffuse large B-cell lymphoma is controversial because of the low risk of CNS relapse (≈5 %) in this population. The risk models that aim to identify predictors of CNS relapse in NHL.