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中枢神经系统淋巴瘤:评估、治疗及中枢神经系统复发的预防

英文原题:Central nervous system lymphomas-Assessment and treatment and prevention of central nervous system relapse.

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Central nervous system lymphomas-Assessment and treatment and prevention of central nervous system relapse.

PubMed 2023/06/29(内容时间) Hematol Oncol Q1 · IF 4.1(JCR 2025)

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中文摘要

在这篇聚焦于淋巴瘤与中枢神经系统(CNS)的综述中,我们总结了原发性(PCNSL)和继发性中枢神经系统淋巴瘤(SCNSL)管理的最新进展、老年人群中中枢神经系统淋巴瘤的治疗、中枢神经系统淋巴瘤的神经影像学评估,最后重点讨论了关于最佳中枢神经系统预防的持续争议。PCNSL部分聚焦于欧洲和美国一线治疗可用的不同方案,并讨论了巩固治疗策略。随后我们重点介绍了老年人群中治疗PCNSL的可用策略,这是一个未满足需求的领域。针对这些患者,旨在最小化毒性并优先考虑生活质量的新疗法正在涌现。继发性中枢神经系统淋巴瘤,尤其是在复发/难治性情况下,是另一个未满足需求的领域,CAR-T 细胞疗法的疗效正在被探索。我们概述了中枢神经系统淋巴瘤神经影像学评估中的成像挑战。最后,关于中枢神经系统预防的部分总结了近期大型回顾性研究的发现,这些研究对当前用于高风险淋巴瘤患者预防方法的疗效提出了质疑。

展开英文摘要原文

In this review focused on lymphoma and the central nervous system (CNS), we summarize recent developments in the management of primary (PCNSL) and secondary CNS lymphoma (SCNSL), treatment of CNS lymphoma in the older population, the neuroradiological assessment of CNS lymphoma and finally highlight the ongoing debate on optimal CNS prophylaxis. The section on PCNSL focuses on the different approaches available for frontline treatment in Europe and the United States and discusses consolidation strategies.

We then highlight available strategies to treat PCNSL in the elderly population, an area of unmet need. New therapies aiming at minimizing toxicity and prioritizing quality of life are emerging for these patients. Secondary CNS lymphoma, especially in the relapsed/refractory setting is another area of unmet need, and the efficacy of CAR-T cell therapy is being explored.

We provide an overview of the imaging challenges in the neuroradiological assessment of CNS lymphoma.

Finally, the section on CNS prophylaxis summarizes recent findings from large retrospective studies challenging the efficacy of present approaches to prophylaxis in higher-risk patients with lymphoma.

论文信息

作者
Ghione P、Lewis KL、Bobillo S、Nayak L、Schorb E、Nichelli L、Ng A、Savage KJ
第一作者单位
Memorial Sloan Kettering Cancer Center, New York, New York, USA.United States
通讯作者单位
University College London Hospitals, London, UK.United Kingdom
文献类型
综述
期刊
Hematological oncology2024 Nov
原文标识
PubMed 37381737 · DOI 10.1002/hon.3197