Intravascular Lymphoma in the CNS: Options for Treatment
#MMPMID28831736
Nizamutdinov D
; Patel NP
; Huang JH
; Fonkem E
Curr Treat Options Neurol
2017[Aug]; 19
(10
): 35
PMID28831736
show ga
Purpose of review The purpose of this review was to discuss therapeutic
manipulations and effective current interventions available to treat
intravascular lymphoma in the central nervous system. Recent findings Patients
experienced resolution and remission of disease for 14 months and up to 2 years
after eight cycles of R-CHOP and four courses of intrathecal therapy with MTX,
cytarabine, and prednisolone. Intravascular use of unfractionated heparin during
therapy may contribute to better outcome. Summary Series of therapeutic avenues
were analyzed and compared. The effective current treatment of intravascular
lymphoma in the CNS is considered to be a combinational intrathecal
methotrexate-based chemotherapy with rituximab. Since intrathecal administration
bypasses the blood-brain barrier, lower doses can be given, which thereby
minimizes systemic toxicity. Practical use of intrathecal chemotherapy is also
justified for prophylaxis in intravascular lymphoma-diagnosed patients without
CNS involvement.