Abstract
Simple SummaryPrimary central nervous system lymphoma (PCNSL) is a rare form of cancer and the treatment of newly diagnosed patients is challenging. Many chemotherapy regimens are being used, and methotrexate is an important component in most. The role of the immunotherapy rituximab is not as clear. This review focuses on the available evidence for the use of this monoclonal antibody in the treatment of patients with PCNSL.Primary central nervous system lymphoma (PCNSL) is a type of non-Hodgkin lymphoma limited to the central nervous system. It has a poor prognosis. Consensus has been reached on the treatment of newly diagnosed patients with high-dose methotrexate-based chemotherapy, but whether the addition of the monoclonal anti-CD20 antibody rituximab improves survival, as it does in systemic B-cell non-Hodgkin lymphoma, remains disputed. In this review, we reflect on the available evidence of the use of rituximab in PCNSL. Whether rituximab has any beneficial effect remains uncertain.
Highlights
Primary central nervous system lymphoma (PCNSL) is a non-Hodgkin lymphoma limited to the central nervous system [1]
Papers with an abstract written in English were taken into consideration. This query resulted in 690 records, which were screened on title and abstract, and after the exclusion of 682 records for obvious ineligibility, the remaining 8 reports were assessed for eligibility
It was postulated that the efficacy of intravenously administered rituximab in PCNSL was limited by the blood–brain barrier, with the cerebrospinal fluid concentration reaching only 0.1% of serum concentration after intravenous administration [40]
Summary
Primary central nervous system lymphoma (PCNSL) is a non-Hodgkin lymphoma limited to the central nervous system (brain, leptomeninges, spinal cord and eyes) [1]. It is a unique World Health Organization (WHO) hematological entity and a rare form of cancer, accounting for 3% of all brain malignancies, with an age-standardized incidence of. The International Extranodal Lymphoma Study Group (IELSG) identified the following independent predictors of poor prognosis in PCNSL: age above 60 years, Eastern Cooperative Oncology Group (ECOG) performance status greater than 1, elevated serum lactate dehydrogenase (LDH) level, elevated cerebral spinal fluid protein concentration, and the involvement of deep regions of the brain. A similar validated prognostic model from the Memorial Sloan-Kettering
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