Preview

Онкогематология

Расширенный поиск

Лечение первичных лимфом центральной нервной системы

https://doi.org/10.17650/1818-8346-2021-16-2-10-20

Полный текст:

Аннотация

Первичные лимфомы центральной нервной системы (ПЛЦНС) – редкая форма экстранодальных лимфом, характеризующаяся агрессивным течением. В последние десятилетия терапия этого заболевания претерпела существенные изменения. Современное лечение ПЛЦНС состоит из 2 этапов – индукции и консолидации ремиссии. Увеличение общей выживаемости больных ПЛЦНС было достигнуто за счет использования комбинированных схем иммунохимиотерапии с включением высоких доз метотрексата и/или цитарабина, которые в настоящее время являются стандартом индукционной терапии. Выполнение высокодозной химиотерапии с последующей аутологичной трансплантацией гемопоэтических стволовых клеток на этапе консолидации обеспечивает наиболее полную элиминацию остаточного опухолевого клона. Наиболее эффективны режимы кондиционирования с включением тиотепы. У пожилых и коморбидных пациентов, не являющихся кандидатами для аутологичной трансплантации гемопоэтических стволовых клеток, многообещающие результаты получены при использовании поддерживающей терапии с применением прокарбазина или темозоломида, а дальнейшие исследования позволят изучить эффективность моноколональных анти-CD20-антител – ритуксимаба и обинутузумаба.

Возможности лечения пациентов с рецидивами и/или рефрактерными формами ПЛЦНС ограниченны. Определенные успехи получены при использовании новых препаратов – ибрутиниба, ниволумаба, леналидомида, обинутузумаба.

Об авторах

И. В. Черкашина
Московский научно-исследовательский онкологический институт им. П.А. Герцена - филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Минздрава России
Россия

Ирина Васильевна Черкашина

125284 Москва, 2-й Боткинский проезд, 3



М. А. Вернюк
Московский научно-исследовательский онкологический институт им. П.А. Герцена - филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Минздрава России
Россия


А. М. Червонцева
Московский научно-исследовательский онкологический институт им. П.А. Герцена - филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Минздрава России
Россия

125284 Москва, 2-й Боткинский проезд, 3



Е. Е. Гущина
Московский научно-исследовательский онкологический институт им. П.А. Герцена - филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Минздрава России
Россия

125284 Москва, 2-й Боткинский проезд, 3



Л. С. Хайруллина
Московский научно-исследовательский онкологический институт им. П.А. Герцена - филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Минздрава России
Россия

125284 Москва, 2-й Боткинский проезд, 3



В. В. Лунин
Московский научно-исследовательский онкологический институт им. П.А. Герцена - филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Минздрава России
Россия

125284 Москва, 2-й Боткинский проезд, 3



П. А. Зейналова
Клинический госпиталь «Лапино» группы компаний «Мать и дитя»
Россия

43081 Московская обл., д. Лапино, 1-е Успенское шоссе, 111



А. А. Феденко
Московский научно-исследовательский онкологический институт им. П.А. Герцена - филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Минздрава России
Россия

125284 Москва, 2-й Боткинский проезд, 3



Список литературы

1. Villano J.L., Koshy M., Shaikh H. et al. Age, gender, and racial differences in incidence and survival in primary CNS lymphoma. Br J Cancer 2011;105(9): 1414–8. DOI: 10.1038/bjc.2011.357.

2. Bataille B., Delwail V., Menet E. et al. Primary intracerebral malignant lymphoma: Report of 248 cases. J Neurosurg 2000;92(2):261–6. DOI: 10.3171/jns.2000.92.2.0261.

3. Grimm S.A., Pulido J.S., Jahnke K. et al. Primary intraocular lymphoma: an international primary central nervous system lymphoma collaborative group report. Ann Oncol 2007;18(11):1851–5. DOI: 10.1093/annonc/mdm340.

4. Korfel A., Weller M., Martus P. et al. Prognostic impact of meningeal dissemination in primary CNS lymphoma (PCNSL): Experience from the G-PCNSL-SG1 trial. Ann Oncol 2012;23(9):2374–80. DOI: 10.1093/annonc/mdr627.

5. Abrey L.E., Ben-Porat L., Panageas K.S. et al. Primary central nervous system lymphoma: the Memorial Sloan– Kettering Cancer Center prognostic model. J Clin Oncol 2006;24(36):5711–5. DOI: 10.1200/JCO.2006.08.2941.

6. Mohile N.A., de Angelis L.M., Abrey L.E. The utility of body FDG PET in staging primary central nervous system lymphoma. Neuro Oncol 2008;10(2):223–8. DOI: 10.1215/15228517-2007-061.

7. Küker W., Nägele T., Korfel A. et al. Primary central nervous system lymphomas (PCNSL): MRI features at presentation in 100 patients. J Neurooncol 2005;72(2): 169–77. DOI: 10.1007/s11060-004-3390-7.

8. Nabavizadeh S.A., Vossough A., Hajmomenian M. et al. Neuroimaging in central nervous system lymphoma. Hematol Oncol Clin North Am 2016;30(4):799–821. DOI: 10.1016/j.hoc.2016.03.005.

9. Barajas R.F., Rubenstein J.L., Chang J.S. et al. Diffusion-weighted MR imaging derived apparent diffusion coefficient is predictive of clinical outcome in primary central nervous system lymphoma. Am J Neuroradiol 2010;31(1):60–6. DOI: 10.3174/ajnr.A1750.

10. Pels H., Juergens A., Schirgens I. et al. Early complete response during chemotherapy primary CNS lymphoma. Neuro Oncol 2010;12(7):720–4.DOI: 10.1093/neuonc/noq010.

11. Gupta M., Gupta T., Purandare N. et al. Utility of flouro-deoxy-glucose positron emission tomography/computed tomography in the diagnostic and staging evaluation of patients with primary CNS lymphoma. CNS Oncol 2019;8(4):CNS46.DOI: 10.2217/cns-2019-0016.

12. Hoang-Xuan K., Bessell E., Bromberg J. et al. Diagnosis and treatment of primary CNS lymphoma in immunocompetent patients: Guidelines from the European Association for Neuro-Oncology. Lancet Oncol 2015;16(7):e322–32. DOI: 10.1016/S1470-2045(15)00076-5.

13. Swerdlow S.H., Campo E., Pileri S.A. et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood 2016;127(20):2375–90. DOI: 10.1182/blood-2016-01-643569.

14. Giannini C., Dogan A., Salomão D.R. CNS lymphoma: a practical diagnostic approach. J Neuropathol Exp Neurol 2014;73(6):478–94. DOI: 10.1097/NEN.0000000000000076.

15. Villa D., Tan K.L., Steidl C. et al. Molecular features of a large cohort of primary central nervous system lymphoma using tissue microarray. Blood Adv 2019;3(23):3953–61. DOI: 10.1182/bloodadvances.2019000989.

16. Kreher S., Jöhrens K., Strehlow F. et al. Prognostic impact of B-cell lymphoma 6 in primary CNS lymphoma. Neuro Oncol 2015;17(7):1016–21. DOI: 10.1093/neuonc/nov046.

17. Lossos C., Bayraktar S., Weinzierl E. et al. LMO2 and BCL6 are associated with improved survival in primary central nervous system lymphoma. Br J Haematol 2014;165(5):640–8. DOI: 10.1111/bjh.12801.

18. Chapuy B., Roemer M.G.M., Stewart C. et al. Targetable genetic features of primary testicular and primary central nervous system lymphomas. Blood 2016;127(7):869–81. DOI: 10.1182/blood-2015-10-673236.

19. Rubenstein J.L., Wong V.S., Kadoch C. et al. CXCL13 plus interleukin 10 is highly specific for the diagnosis of CNS lymphoma. Blood 2013;121(23):4740–8. DOI: 10.1182/blood-2013-01-476333.

20. Ferry J.A., Pfannl R., Harris N.L. Lymphoma and leukemia of the nervous system. Lymphoma Leuk Nerv Syst 2012:61–86. DOI: 10.1007/978-1-4419-7668-0.

21. Ostrom Q.T., Gittleman H., Liao P. et al. CBTRUS Statistical Report: Primary brain and other central nervous system tumors diagnosed in the United States in 2010–2014. Neuro Oncol 2017;19(5):v1–88. DOI: 10.1093/neuonc/nox158.

22. Mendez J.S., Ostrom Q.T., Gittleman H. et al. The elderly left behind-changes in survival trends of primary central nervous system lymphoma over the past 4 decades. Neuro Oncol 2018;20(5):687–94. DOI: 10.1093/neuonc/nox187.

23. Ferreri A.J.M., Blay J.Y., Reni M. et al. Prognostic scoring system for primary CNS lymphomas: the International Extranodal Lymphoma Study Group experience. J Clin Oncol 2003;21(2):266–72. DOI: 10.1200/JCO.2003.09.139.

24. Mendez J.S., Grommes C. Treatment of primary central nervous system lymphoma: from chemotherapy to small molecules. Am Soc Clin Oncol Educ Book 2018;38:604–15. DOI: 10.1200/EDBK_200829.

25. Jang J.E., Kim Y.R., Kim S.J. et al. A new prognostic model using absolute lymphocyte count in patients with primary central nervous system lymphoma. Eur J Cancer 2016;57:127–35. DOI: 10.1016/j.ejca.2016.01.016.

26. Bellinzona M., Roser F., Ostertag H. et al. Surgical removal of primary central nervous system lymphomas (PCNSL) presenting as space occupying lesions: a series of 33 cases. Eur J Surg Oncol 2005;31(1):100–5. DOI: 10.1016/j.ejso.2004.10.002.

27. Deng X., Xu X., Lin D. et al. Real-world impact of surgical excision on overall survival in primary central nervous system lymphoma. Front Oncol 2020;10:131. DOI: 10.3389/fonc.2020.00131.

28. Weller M., Martus P., Roth P. et al. Surgery for primary CNS lymphoma? Challenging a paradigm. Neuro Oncol 2012;14(12):1481–4. DOI: 10.1093/neuonc/nos159.

29. Manoj N., Arivazhagan A., Mahadevan A. et al. Central nervous system lymphoma: patterns of incidence in Indian population and effect of steroids on stereotactic biopsy yield. Neurol India 2014;62(1):19–25. DOI: 10.4103/0028-3886.128272.

30. Milgrom S.A., Yahalom J. The role of radiation therapy in the management of primary central nervous system lymphoma. Leuk Lymphoma 2015;56(5):1197–204. DOI: 10.3109/10428194.2014.961014.

31. Omuro A., Correa D.D., de Angelis L.M. et al. R-MPV followed by high-dose chemotherapy with TBC and autologous stem-cell transplant for newly diagnosed primary CNS lymphoma. Blood 2015;125(9):1403–10. DOI: 10.1182/blood-2014-10-604561.

32. Correa D.D., Shi W., Abrey L.E. et al. Cognitive functions in primary CNS lymphoma after single or combined modality regimens. Neuro Oncol 2012;14(1):101–8. DOI: 10.1093/neuonc/nor186.

33. Batchelor T., Carson K., O’Neill A. et al. Treatment of pimary CNS lymphoma with methotrexate and deferred radiotherapy: a report of NABTT 96-07. J Clin Oncol 2003;21(6):1044–9. DOI: 10.1200/JCO.2003.03.036.

34. Correa D.D., Rocco-Donovan M., de Angelis L.M. et al. Prospective cognitive follow-up in primary CNS lymphoma patients treated with chemotherapy and reduced-dose radiotherapy. J Neurooncol 2009;91(3):315–21. DOI: 10.1007/s11060-008-9716-0.

35. Doolittle N.D., Korfel A., Lubow M.A. et al. Long-term cognitive function, neuroimaging, and quality of life in primary CNS lymphoma. Neurology 2013;81(1):84–92. DOI: 10.1212/WNL.0b013e318297eeba.

36. Ferreri A.J.M., Cwynarski K., Pulczynski E. et al. Chemoimmunotherapy with methotrexate, cytarabine, thiotepa, and rituximab (MATRix regimen) in patients with primary CNS lymphoma: results of the first randomisation of the International Extranodal Lymphoma Study Group-32 (IELSG32) phase 2 trial. Lancet Haematol 2016;3(5):e217–27. DOI: 10.1016/S2352-3026(16)00036-3.

37. Glass J., Won M., Schultz C.J. et al. Phase I and II study of induction chemotherapy with methotrexate, rituximab, and temozolomide, followed by wholebrain radiotherapy and postirradiation temozolomide for primary CNS lymphoma: NRG oncology RTOG 0227. J Clin Oncol 2016;34(14):1620–5. DOI: 10.1200/JCO.2015.64.8634.

38. Morris P.G., Correa D.D., Yahalom J. et al. Rituximab, methotrexate, procarbazine, and vincristine followed by consolidation reduced-dose wholebrain radiotherapy and cytarabine in newly diagnosed primary CNS lymphoma: final results and long-term outcome. J Clin Oncol 2013;31(31):3971–9. DOI: 10.1200/JCO.2013.50.4910.

39. Herrlinger U., Schäfer N., Fimmers R. et al. Early whole brain radiotherapy in primary CNS lymphoma: negative impact on quality of life in the randomized G-PCNSL-SG1 trial. J Cancer Res Clin Oncol 2017;143(9):1815–21. DOI: 10.1007/s00432-017-2423-5.

40. Ferreri A.J.M. How I treat primary CNS lymphoma. Blood 2011;118(3):510–22. DOI: 10.1182/blood-2011-03-321349.

41. Han C.H., Batchelor T.T. Diagnosis and management of primary central nervous system lymphoma. Cancer 2017;123(22):4314–24. DOI: 10.1002/ cncr.30965.

42. Kasenda B., Ihorst G., Schroers R. et al. High-dose chemotherapy with autologous haematopoietic stem cell support for relapsed or refractory primary CNS lymphoma: a prospective multicentre trial by the German Cooperative PCNSL study group. Leukemia 2017;31(12):2623–9. DOI: 10.1038/leu.2017.170.

43. Ferreri A.J., Reni M., Foppoli M. et al. High-dose cytarabine plus high-dose methotrexate versus high-dose methotrexate alone in patients with primary CNS lymphoma: a randomised phase 2 trial. Lancet 2009;374(9700):1512–20. DOI: 10.1016/S0140-6736(09)61416-1.

44. Schorb E., Fox C.P., Fritsch K. et al. High-dose thiotepa-based chemotherapy with autologous stem cell support in elderly patients with primary central nervous system lymphoma: a European retrospective study. Bone Marrow Transplant 2017;52(8):1113–9. DOI: 10.1038/bmt.2017.23.

45. Kasenda B., Ferreri A.J.M., Marturano E. et al. First-line treatment and outcome of elderly patients with primary central nervous system lymphoma (PCNSL) – a systematic review and individual patient data meta-analysis. Ann Oncol 2015;26(7):1305–13. DOI: 10.1093/annonc/mdv076.

46. Ferreri A.J.M., Illerhaus G. The role of autologous stem cell transplantation in primary central nervous system lymphoma. Blood 2016;127(33):1642–9. DOI: 10.1182/blood-2015-10-636340.

47. Rubenstein J.L., Hsi E.D., Johnson J.L. et al. Intensive chemotherapy and immunotherapy in patients with newly diagnosed primary CNS lymphoma: CALGB 50202 (Alliance 50202). J Clin Oncol 2013;31(25):3061–8. DOI: 10.1200/JCO.2012.46.9957.

48. Omuro A., Chinot O., Taillandier L. et al. Methotrexate and temozolomide versus methotrexate, procarbazine, vincristine, and cytarabine for primary CNS lymphoma in an elderly population: an intergroup ANOCEF-GOELAMS randomised phase 2 trial. Lancet Haematol 2015;2(6):e251–9. DOI: 10.1016/S2352- 3026(15)00074-5.

49. Poortmans P.M.P., Kluin-Nelemans H.C., Haaxma-Reiche H. et al. High-dose methotrexate-based chemotherapy followed by consolidating radiotherapy in non-AIDS-related primary central nervous system lymphoma: European Organization for Research and Treatment of Cancer Lymphoma Group Phase II Trial 20962. J Clin Oncol 2003;21(24):4483–8. DOI: 10.1200/JCO.2003.03.108.

50. Rubenstein J.L., Combs D., Rosenberg J. et al. Rituximab therapy for CNS lymphomas: targeting the leptomeningeal compartment. Blood 2003;101(2):466–8. DOI: 10.1182/blood-2002-06-1636.

51. Shah G.D., Yahalom J., Correa D.D. et al. Combined immunochemotherapy with reduced whole-brain radiotherapy for newly diagnosed primary CNS lymphoma. J Clin Oncol 2007;25(30):4730–5. DOI: 10.1200/JCO.2007.12.5062.

52. Bromberg J.E.C., Issa S., Bakunina K. et al. Rituximab in patients with primary CNS lymphoma (HOVON 105/ALLG NHL 24): a randomised, open-label, phase 3 intergroup study. Lancet Oncol 2019;20(2):216–28. DOI: 10.1016/S1470-2045(18)30747-2.

53. Houillier C., Ghesquières H., Cécile C. et al. Rituximab, methotrexate, procarbazine, vincristine and intensified cytarabine consolidation for primary central nervous system lymphoma (PCNSL) in the elderly: a LOC network study. J Neurooncol 2017;133(2):315–20. DOI: 10.1007/s11060-017-2435-7.

54. Schorb E., Fox C.P., Kasenda B. et al. Induction therapy with the MATRix regimen in patients with newly diagnosed primary diffuse large B-cell lymphoma of the central nervous system – an international study of feasibility and efficacy in routine clinical practice. Br J Haematol 2020;189(5):879–87. DOI: 10.1111/bjh.16451.

55. Fox C.P., Phillips E.H., Smith J. et al. Guidelines for the diagnosis and management of primary central nervous system diffuse large B-cell lymphoma. Br J Haematol 2019;184(3):348–63. DOI: 10.1111/bjh.15661.

56. Nelson D.F., Martz K.L., Bonner H. et al. Non-Hodgkin’s lymphoma of the brain: Can high dose, large volume radiation therapy improve survival? Report on a prospective trial by the Radiation therapy Oncology Group (RTOG): RTOG 8315. Int J Radiat Oncol Biol Phys 1992;23(1):9–17. DOI: 10.1016/0360- 3016(92)90538-S.

57. Kurzwelly D., Glas M., Roth P. et al. Primary CNS lymphoma in the elderly: temozolomide therapy and MGMT status. J Neurooncol 2010;97(3):389–92. DOI: 10.1007/s11060-009-0032-0.

58. Khan R.B., Shi W., Thaler H.T. et al. Is intrathecal methotrexate necessary in the treatment of primary CNS lymphoma? J Neurooncol 002;58(2):175–8. DOI: 10.1023/A:1016077907952.

59. Pels H., Juergens A., Glasmacher A. et al. Early relapses in primary CNS lymphoma after response to polychemotherapy without intraventricular treatment: results of a phase II study. J Neurooncol 2009;91(3):299–305. DOI: 10.1007/s11060-008-9712-4.

60. Rubenstein J.L., Fridlyand J., Abrey L. et al. Phase I study of intraventricular administration of rituximab in patients with recurrent CNS and intraocular lymphoma. J Clin Oncol 2007;25(11):1350–6. DOI: 10.1200/JCO.2006.09.7311.

61. Soussain C., Choquet S., Fourme E. et al. Intensive chemotherapy with thiotepa, busulfan and cy clophosphamide and hematopoietic stem cell rescue in relapsed or refractory primary central nervous system lymphoma and intraocular lymphoma: a retrospective study of 79 cases. Haematologica 2012;97(11):1751–6. DOI: 10.3324/haematol.2011.060434.

62. Ferreri A.J.M., Cwynarski K., Pulczynski E. et al. Whole-brain radiotherapy or autologous stem-cell transplantation as consolidation strategies after high-dose methotrexate-based chemoimmunotherapy in patients with primary CNS lymphoma: results of the second randomisation of the International Extranodal L. Lancet Haematol 2017;4(11):e510–23. DOI: 10.1016/S2352-3026(17)30174-6.

63. Houillier C., Taillandier L., Dureau S. et al. Radiotherapy or autologous stem-cell transplantation for primary CNS lymphoma in patients 60 years of age and younger: results of the Intergroup ANOCEF-GOELAMS randomized phase II PRECIS study. J Clin Oncol 2019;37:823–33. DOI: 10.1200/JCO.18.

64. Abrey L.E., Moskowitz C.H., Mason W.P. et al. Intensive methotrexate and cytarabine followed by high-dose chemotherapy with autologous stem-cell rescue in patients with newly diagnosed primary CNS lymphoma: an intent-totreat analysis. J Clin Oncol 2003;21(22):4151–6. DOI: 10.1200/JCO.2003.05.024.

65. Cho H., Chang J.H., Kim Y.R. et al. The role of upfront autologous stem cell transplantation in high-risk younger patients with primary central nervous system lymphoma. Br J Haematol 2016;174(3):444–53. DOI: 10.1111/bjh.14069.

66. Kiefer T., Hirt C., Späth C. et al. Longterm follow-up of high-dose chemotherapy with autologous stem-cell transplantation and response-adapted whole-brain radiotherapy for newly diagnosed primary CNS lymphoma: results of the multicenter Studiengruppe Hamatologie und Onkologie OSHO-53 phase II study. Ann Oncol 2012;23(7):1809–12. DOI: 10.1093/annonc/mdr553.

67. Brem S.S., Bierman P.J., Black P. et al. Central nervous system cancers. J Natl Compr Canc Netw 2008;6(5):456–504. DOI: 10.6004/jnccn.2008.0037.

68. Fritsch K., Kasenda B., Schorb E. et al. High-dose methotrexate-based immunochemotherapy for elderly primary CNS lymphoma patients (PRIMAIN study). Leukemia 2017;31(4):846–52. DOI: 10.1038/leu.2016.334.

69. Pulczynski E.J., Kuittinen O., Erlanson M. et al. Successful change of treatment strategy in elderly patients with primary central nervous system lymphoma by deescalating induction and introducing temozolomide maintenance: results from a phase II study by the Nordic Lymphoma Group. Haematologica 2015;100(4):534–40. DOI: 10.3324/ haematol.2014.108472.

70. Ambady P., Fu R., Szidonya L. et al. Impact of maintenance rituximab on duration of response in primary central nervous system lymphoma. J Neurooncol 2020;147(1):171–6. DOI: 10.1007/s11060-020-03411-0.

71. Langner-Lemercier S., Houillier C., Soussain C. et al. Primary CNS lymphoma at first relapse/progression: characteristics, management, and outcome of 256 patients from the French LOC network. Neuro Oncol 2016;18(9):1297–303. DOI: 10.1093/neuonc/now033.

72. Plotkin S.R., Betensky R.A., Hochberg F.H. et al. Treatment of relapsed central nervous system lymphoma with high-dose methotrexate. Clin Cancer Res 2004;10(17):5643–6. DOI: 10.1158/1078-0432.CCR-04-0159.

73. Pentsova E., Deangelis L.M., Omuro A. Methotrexate re-challenge for recurrent primary central nervous system lymphoma. J Neurooncol 2014;117(1):161–5. DOI: 10.1007/s11060-014-1370-0.

74. Nguyen P.L., Chakravarti A., Finkelstein D.M. et al. Results of wholebrain radiation as salvage of methotrexate failure for immunocompetent patients with primary CNS lymphoma. J Clin Oncol 2005;23(7):1507–13. DOI: 10.1200/JCO.2005.01.161.

75. Khimani N.B., Ng A.K., Chen Y.H. et al. Salvage radiotherapy in patients with recurrent or refractory primary or secondary central nervous system lymphoma after methotrexate-based chemotherapy. Ann Oncol 2011;22(4):979–84. DOI: 10.1093/annonc/mdq548.

76. Motomura K., Natsume A., Fujii M. et al. Long-term survival in patients with newly diagnosed primary central nervous system lymphoma treated with dexamethasone, etoposide, ifosfamide and carboplatin chemotherapy and whole-brain radiation therapy. Leuk Lymphoma 2011;52(11):2069–75. DOI: 10.3109/10428194.2011.596967.

77. Mappa S., Marturano E., Licata G. et al. Salvage chemoimmunotherapy with rituximab, ifosfamide and etoposide (R-IE regimen) in patients with primary CNS lymphoma relapsed or refractory to high-dose methotrexate-based chemotherapy. Hematol Oncol 2013;31(3):143–50. DOI: 10.1002/hon.2037.

78. Arellano-Rodrigo E., López-Guillermo A., Bessell E.M. et al. Salvage treatment with etoposide (VP-16), ifosfamide and cytarabine (Ara-C) for patients with recurrent primary central nervous system lymphoma. Eur J Haematol 2003;70(4):219–24. DOI: 10.1034/j.1600-0609.2003.00045.x.

79. Reni M., Mazza E., Foppoli M. et al. Primary central nervous system lymphomas: salvage treatment after failure to high-dose methotrexate. Cancer Lett 2007;258(2):165–70. DOI: 10.1016/j.canlet.2007.10.009.

80. Tyson R.M., Siegal T., Doolittle N.D. et al. Current status and future of relapsed primary central nervous system lymphoma (PCNSL). Leuk Lymphoma 2003;44(4):627–33. DOI: 10.1080/1042819021000055057.

81. Enting R.H., Demopoulos A., de Angelis L.M. et al. Salvage therapy for primary CNS lymphoma with a combination of rituximab and temozolomide. Neurology 2004;63(5):901–3. DOI: 10.1212/01.WNL.0000137050.43114.42.

82. Jahnke K., Thiel E., Martus P. et al. Relapse of primary central nervous system lymphoma: clinical features, outcome and prognostic factors. J Neurooncol 2006;80(2):159–65. DOI: 10.1007/ s11060-006-9165-6.

83. Fischer L., Thiel E., Klasen H.A. et al. Prospective trial on topotecan salvage therapy in primary CNS lymphoma. Ann Oncol 2006;17(7):1141–5. DOI: 10.1093/annonc/mdl070.

84. Raizer J.J., Rademaker A., Evens A.M. et al. Pemetrexed in the treatment of relapsed/refractory primary central nervous system lymphoma. Cancer 2012;118(15):3743–8. DOI: 10.1002/cncr.26709.

85. Nayak L., Abrey L.E., Drappatz J. et al. Multicenter phase II study of rituximab and temozolomide in recurrent primary central nervous system lymphoma. Leuk Lymphoma 2013;54(1):58–61. DOI: 10.3109/10428194.2012.698736.

86. Grommes C., Pastore A., Palaskas N. et al. Ibrutinib unmasks critical role of bruton tyrosine kinase in primary CNS lymphoma. Cancer Discov 2017;7(9):1018–29. DOI: 10.1158/2159-8290.CD-17-0613.

87. Nayak L., Iwamoto F.M., LaCasce A. et al. PD-1 blockade with nivolumab in relapsed/refractory primary central nervous system and testicular lymphoma. Blood 2017;129(23):3071–3. DOI: 10.1182/blood-2017-01-764209.

88. Rubenstein J.L., Geng H., Fraser E.J. et al. Phase 1 investigation of lenalidomide/rituximab plus outcomes of lenalidomide maintenance in relapsed CNS lymphoma. Blood Adv 2018;2(13):1595–607. DOI: 10.1182/bloodadvances.2017014845.

89. Shi X.X., Miao W.M., Pang D.W. et al. Angiopep-2 conjugated nanoparticles loaded with doxorubicin for the treatment of primary central nervous system lymphoma. Biomater Sci 2020;8(5):1290–7. DOI: 10.1039/c9bm01750j.


Для цитирования:


Черкашина И.В., Вернюк М.А., Червонцева А.М., Гущина Е.Е., Хайруллина Л.С., Лунин В.В., Зейналова П.А., Феденко А.А. Лечение первичных лимфом центральной нервной системы. Онкогематология. 2021;16(2):10-20. https://doi.org/10.17650/1818-8346-2021-16-2-10-20

For citation:


Cherkashina I.V., Vernyuk M.A., Chervontseva A.M., Gushchina E.E., Khayrullina L.S., Lunin V.V., Zeynalova P.A., Fedenko A.A. Treatment of primary central nervous system lymphomas. Oncohematology. 2021;16(2):10-20. (In Russ.) https://doi.org/10.17650/1818-8346-2021-16-2-10-20

Просмотров: 86


Creative Commons License
Контент доступен под лицензией Creative Commons Attribution 4.0 License.


ISSN 1818-8346 (Print)
ISSN 2413-4023 (Online)