OncohematologyOncohematologyОнкогематология1818-83462413-4023Publishing House ABV Press9010.17650/1818-8346-2011-6-3-50-56HEMATOLOGIC MALIGNANCIES: DIAGNOSIS, TREATMENT, SUPPORTIVE CAREГЕМОБЛАСТОЗЫ: ДИАГНОСТИКА, ЛЕЧЕНИЕ, СОПРОВОДИТЕЛЬНАЯ ТЕРАПИЯTreatment of central nervous system lymphoma — literature review and own experiencesЛечение лимфом центральной нервной системы — обзор литературы и собственные данныеMinenkoS. V.МиненкоС. В.
Russian Federation
svetlanaminenko@yandex.ruLarinaYu. V.ЛаринаЮ. В.
Russian Federation
PtushkinV. V.ПтушкинВ. В.
Russian Federation
KhuazhevaN. K.ХуажеваН. К.
Russian Federation
LuninV. V.ЛунинВ. В.
Russian Federation
PerestoroninaT. N.ПересторонинаТ. Н.
Russian Federation
BiyachuevE. R.БиячуевЭ. Р.
Russian Federation
PshonkinA. V.ПшонкинА. В.
Russian Federation
SemochkinS. V.СемочкинС. В.
Russian Federation
SheikhZh. V.ШейхЖ. В.
Russian Federation
YakovlevV. N.ЯковлевВ. Н.
Russian Federation
AlekseevV. G.АлексеевВ. Г.
Russian Federation
Federal Research Center of Pediatric Hematology, Oncology and ImmunologyФГБУ Федеральный научно-клинический центр детской гематологии, онкологии и иммунологии им. Дмитрия Рогачева Минздравсоцразвития РоссииBotkin Municipal Clinical HospitalГУЗ Городская клиническая больница им. С.П. Боткинаru2308201120116350562307201423072014Received:23072014Accepted:23072014Published:230820112011https://oncohematology.abvpress.ru/ongm/article/view/90

Central nervous system (CNS) involvement in advanced non-Hodgkin’s lymphoma (NHL) occurs in 5–29 % of cases. Primary CNS lymphoma (PLCNS) significantly less revealed: 1–2 % of lymphoma cases and 5 % of all malignant CNS diseases. Historically, PLCNS treated with radiotherapy, but the majority of patients had no long-term remission. Combined treatment (chemotherapy + radiation therap y) has been developed to improve radiotherapy efficacy. The research results, according to several authors, allowed to develop the bas is of modern medical approaches, which includes a combination of high-doses methotrexate and cytarabine with radiation therapy for remission consolidation. New drugs — temozolomide, topotecan and rituximab — in combination with conventional preparates have been studied. Treatment results of 11 patients with primary (8) or secondary (3) CNS lymphomas treated in Botkin Municipal Clinical Hospital was analyzed. In 9 from 11 (all with primary lesion) diffuse B-large cell lymphoma w as diagnosed (by immunohistochemistry). All primary patients received 3.5–5 g/m2 methotrexate and 2–4 doses 2 g/m2 cytarabine (except 2 patients); 3 patients in addition received ifosfamide, vincristine and etoposide under a pediatric protocol BFM-90. Subsequently , all patients received 46 Gy cranial irradiation. 75 % of pa tients achieved complete or partial remission. One patient died from infectious complication after 2nd chemotherapy course. 2 patients have early progression. Five patients are alive with follow-up from 6 months to 3.5 years and 4 of them remains in remission. Therapy with methotrexate + cytarabine was accompanied by III–IV grade neutropenia in the majority of patients, but its duration w as not great. The data obtained are consistent with results of modern treatment protocols PLCNS.

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