SOHO State of the Art Updates and Next Questions: Prophylaxis and Management of Secondary CNS Lymphoma |
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| Affiliation: | 1. Leukemia/BMT Program of BC, BC Cancer, Vancouver, BC, Canada;2. Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON, Canada;3. Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada;4. Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, AB, Canada;5. Division of Infectious Diseases, Department of Medicine, University of Alberta, AB, Edmonton, Canada;6. Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, ON, Canada;7. Department of Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute; Morsani College of Medicine, University of South Florida, Tampa, FL, USA;1. Department of Internal Medicine, University of South Florida, Tampa, FL;2. Division of Malignant Hematology, Moffitt Cancer Center, Tampa, FL;3. Department of Malignant Hematology and Cellular Therapy at Memorial Healthcare System, Moffitt Cancer Center, Pembroke Pines, FL;4. Department of Satellite Oncology, Moffitt Cancer Center, Tampa, FL;1. Department of Internal Medicine, Cleveland Clinic Main Campus, Cleveland, OH;2. Sarah Cannon – Nashville TN;1. Department of Internal Medicine, Rochester General Hospital, Rochester, NY;2. Department of Internal Medicine, Jacobi Medical Center, New York, NY;3. Department of Kidney and Hypertension, Rhode Island Hospital, Providence, RI;4. Department of Internal Medicine, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal;5. Department of Internal Medicine, Division of Oncology and Hematology, University of Nebraska Medical Center, Omaha, NE;6. Department of Internal Medicine, Division of Hematology, Oncology, and Blood & Marrow Transplantation, University of Iowa, Iowa City, IA;7. Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE |
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| Abstract: | Secondary CNS lymphoma (SCNSL) is a rare but frequently fatal complication of systemic lymphoma. There is no standard treatment for SCNSL, and patients who develop SCNSL at diagnosis or after frontline therapy often receive highly intensive chemotherapy regimens that are inactive against primary chemorefractory disease and too toxic for older, frail patients to tolerate. Because the prognosis of SCNSL is so poor, management has historically emphasized prevention, but the current methods of CNS prophylaxis are not universally effective. To improve both the prevention and management of SCNSL, better characterization of the molecular determinants of CNS invasion is needed. Novel treatments that are currently being studied in SCNSL include targeted pathway inhibitors and cellular therapy, but SCNSL patients are often excluded from clinical trials of promising new therapies. |
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