非霍奇金淋巴瘤中枢神经系统累及的诊断和预防

 非霍奇金淋巴瘤（NHL）患者中枢神经系统（CNS）累及预后不良，其中位生存期2～6个月。与NHL CNS累及相关参数是年轻、进展期、累及结外部位数、乳酸脱氢酶（LDH）增高和国际预后指标（IPI）积分。最有希望的治疗为自体造血干细胞移植，可延长中数生存期10～26个月。处于CNS侵袭高危状态的某些NHL亚型患者需要早期进行CNS预防，如伯基特淋巴瘤（BL）和淋巴母细胞淋巴瘤（LBL）。弥漫性大B细胞淋巴瘤（DLBCL）初期治疗时是否需应用CNS预防久有争议，因为它属于CNS累及（≈5 ％）的低危群体。危险模式的确定有助于预示NHL的CNS复发。

Advance on diagnosis and prophylaxis of central nervous system involvement in non-Hodgkin lymphoma

Refractory central nervous system （CN5） 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 proinising 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.