title: Central Nervous System Prophylaxis for Aggressive B-cell Lymphoma: Who, What, and When?
abstract: Central nervous system (CNS) relapse of aggressive B-cell lymphoma is a rare but serious complication with poor survival. Different approaches have been used to define risks factors for CNS relapse and establish prophylactic measures. Although patients with low or intermediate risk of CNS relapse should not undergo special diagnostic or therapeutic measures, CNS MRI as well as cytology and flow cytometry of the cerebrospinal fluid are suggested for high-risk patients (and patients with testicular involvement) at diagnosis, and prophylactic high-dose methotrexate in patients without proven CNS involvement. Future risk and treatment models may include molecular features and new treatment options.
authors.affiliation: Department of Hematology, Oncology and Stem Cell Transplantation, Asklepios Hospital St. Georg, Lohmuehlenstrasse 5, Hamburg D-20099, Germany. Electronic address: n.schmitz@asklepios.com.
authors.forename: Norbert
authors.initials: N
authors.lastname: Schmitz
authors.affiliation: Department of Hematology, Oncology and Stem Cell Transplantation, Asklepios Hospital St. Georg, Lohmuehlenstrasse 5, Hamburg D-20099, Germany.
authors.forename: Maike
authors.initials: M
authors.lastname: Nickelsen
authors.affiliation: Department of Medical Oncology, British Columbia Cancer Agency, 600 West 10th Avenue, Vancouver, British Columbia V5Z 4E6, Canada. Electronic address: ksavage@bccancer.bc.ca.
authors.forename: Kerry J
authors.initials: KJ
authors.lastname: Savage
mesh_terms: D016543:Central Nervous System Neoplasms / Q000134:cerebrospinal fluid / Q000000981:diagnostic imaging / Q000517:prevention & control; D006801:Humans; D016393:Lymphoma, B-Cell / Q000134:cerebrospinal fluid / Q000000981:diagnostic imaging / Q000517:prevention & control; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008727:Methotrexate / Q000627:therapeutic use*
chemical_list: D008727:Methotrexate
keywords: B-cell lymphoma; Central nervous system; Prophylaxis