Intrathecal chemotherapy in lymphomatous meningitis

Fabio Canova; Dario Marino; Chiara Trentin; Caterina Soldà; Cristina Ghiotto; Savina Maria Luciana Aversa

doi:10.1016/j.critrevonc.2010.07.005

Intrathecal chemotherapy in lymphomatous meningitis

Crit Rev Oncol Hematol. 2011 Aug;79(2):127-34. doi: 10.1016/j.critrevonc.2010.07.005. Epub 2010 Aug 8.

Authors

Fabio Canova¹, Dario Marino, Chiara Trentin, Caterina Soldà, Cristina Ghiotto, Savina Maria Luciana Aversa

Affiliation

¹ Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy. canova1980@gmail.com

PMID: 20696592
DOI: 10.1016/j.critrevonc.2010.07.005

Abstract

Central Nervous System (CNS) involvement in lymphoma can occur whether at diagnosis or, more often, at the progression or recurrence of disease and the most frequent clinical manifestation is lymphomatous meningitis (LM). The first risk factor for LM development is the histotype, with the highest incidence for highly aggressive non-Hodgkin's lymphomas (NHL) such as Burkitt's lymphoma (BL) and lymphoblastic lymphoma/acute lymphoblastic leukemia (LBL/ALL) and the lowest for indolent NHL. LM prophylaxis in aggressive NHL (other than BL and LBL/ALL) is a much debated question, because the identification of specific risk factors remains controversial. Moreover, there is not a consensus if the LM prophylaxis should consist of systemic chemotherapy (CT), intrathecal (i.t.) CT or both. In case of LM, the i.t. CT has a key role, but there is not a consensus on treatment schedule. Newer intensified regimens and rituximab lead to reconsider the whole approach to LM.

Publication types

Review

MeSH terms

Antibodies, Monoclonal, Murine-Derived / administration & dosage
Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
Central Nervous System Neoplasms / secondary
Cyclophosphamide / administration & dosage
Doxorubicin / administration & dosage
Drug Administration Schedule
Humans
Immunocompetence
Immunocompromised Host
Injections, Spinal / methods*
Leukemic Infiltration
Lymphoma, Non-Hodgkin / diagnosis
Lymphoma, Non-Hodgkin / drug therapy*
Lymphoma, Non-Hodgkin / immunology
Lymphoma, Non-Hodgkin / pathology
Male
Meninges / pathology*
Middle Aged
Precursor Cell Lymphoblastic Leukemia-Lymphoma / diagnosis
Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*
Precursor Cell Lymphoblastic Leukemia-Lymphoma / immunology
Precursor Cell Lymphoblastic Leukemia-Lymphoma / pathology
Prednisone / administration & dosage
Recurrence
Risk Factors
Rituximab
Vincristine / administration & dosage

Substances

Antibodies, Monoclonal, Murine-Derived
Rituximab
Vincristine
Doxorubicin
Cyclophosphamide
Prednisone