Sustained remission and long-term survival of secondary central nervous system involvement by aggressive B-cell lymphoma after combination treatment of systemic high-dose chemotherapy and intrathecal

摘要

In the era of targeted anti-cancer treatment, chemotherapy plus intravenous rituximab significantly improves the treatment response and survival of elderly patients with aggressive B-cell lymphoma . However, the administration of rituximab does not alter the incidence of central nervous system (CNS) recurrence, which, on the basis of recent studies, has been reported to be up to 5% . The CNS relapse occurs in the forms of leptomeningeal involvement or isolated parenchymal involvement, and sometimes both. Managing this secondary CNS involvement remains a great challenge; in particular, elderly patients who have manifestation of leptomeningeal relapse on therapy or after achieving a complete remission usually carry a dismal prognosis #