295
Views
15
CrossRef citations to date
0
Altmetric
Theme: Brain/Neurologic - Review

Pathogenesis and management of primary CNS lymphoma

, , &
Pages 623-633 | Published online: 10 Jan 2014

References

  • Gerstner ER, Batchelor TT. Primary central nervous system lymphoma. Arch. Neurol.67(3), 291–297 (2010).
  • Flanagan EP, O’Neill BP, Porter AB, Lanzino G, Haberman TM, Keegan BM. Primary intramedullary spinal cord lymphoma. Neurology77(8), 784–791 (2011).
  • Schabet M. Epidemiology of primary CNS lymphoma. J. Neurooncol.43(3), 199–201 (1999).
  • Gonzalez-Aguilar A, Soto-Hernandez JL. The management of primary central nervous system lymphoma related to AIDS in the HAART era. Curr. Opin. Oncol.23(6), 648–653 (2011).
  • Mead GM, Bleehen NM, Gregor A et al. A Medical Research Council randomized trial in patients with primary cerebral non-Hodgkin lymphoma: cerebral radiotherapy with and without cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy. Cancer89(6), 1359–1370 (2000).
  • Ferreri AJ, 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. Lancet374(9700), 1512–1520 (2009).
  • Thiel E, Korfel A, Martus P et al. High-dose methotrexate with or without whole brain radiotherapy for primary CNS lymphoma (G-PCNSL-SG-1): a Phase 3, randomised, non-inferiority trial. Lancet Oncol.11(11), 1036–1047 (2010).
  • Deckert-Schluter M, Rang A, Wiestler OD. Apoptosis and apoptosis-related gene products in primary non-Hodgkin’s lymphoma of the central nervous system. Acta Neuropathol.96(2), 157–162 (1998).
  • Nakamura M, Shimada K, Ishida E, Konishi N. Histopathology, pathogenesis and molecular genetics in primary central nervous system lymphomas. Histol. Histopathol.19(1), 211–219 (2004).
  • Bhagavathi S, Sharathkumar A, Hunter S et al. Activated B-cell immunophenotype might be associated with poor prognosis of primary central nervous system lymphomas. Clin. Neuropathol.27(1), 13–20 (2008).
  • Gualco G, Weiss LM, Barber GN, Bacchi CE. Diffuse large B-cell lymphoma involving the central nervous system. Int. J. Surg. Pathol.19(1), 44–50 (2011).
  • Deckert M, Engert A, Bruck W et al. Modern concepts in the biology, diagnosis, differential diagnosis and treatment of primary central nervous system lymphoma. Leukemia25(12), 1797–1807 (2011).
  • Jahnke K, Korfel A, O’Neill BP et al. International study on low-grade primary central nervous system lymphoma. Ann. Neurol.59(5), 755–762 (2006).
  • Lim T, Kim SJ, Kim K et al. Primary CNS lymphoma other than DLBCL: a descriptive analysis of clinical features and treatment outcomes. Ann. Hematol.90(12), 1391–1398 (2011).
  • Shenkier TN, Blay JY, O’Neill BP et al. Primary CNS lymphoma of T-cell origin: a descriptive analysis from the International Primary CNS Lymphoma Collaborative Group. J. Clin. Oncol.23(10), 2233–2239 (2005).
  • Lossos IS, Alizadeh AA, Eisen MB et al. Ongoing immunoglobulin somatic mutation in germinal center B cell-like but not in activated B cell-like diffuse large cell lymphomas. Proc. Natl Acad. Sci. USA97(18), 10209–10213 (2000).
  • Montesinos-Rongen M, Van Roost D, Schaller C, Wiestler OD, Deckert M. Primary diffuse large B-cell lymphomas of the central nervous system are targeted by aberrant somatic hypermutation. Blood103(5), 1869–1875 (2004).
  • Courts C, Montesinos-Rongen M, Martin-Subero JI et al. Transcriptional profiling of the nuclear factor-kappaB pathway identifies a subgroup of primary lymphoma of the central nervous system with low BCL10 expression. J. Neuropathol. Exp. Neurol.66(3), 230–237 (2007).
  • Montesinos-Rongen M, Schmitz R, Brunn A et al. Mutations of CARD11 but not TNFAIP3 may activate the NF-kappaB pathway in primary CNS lymphoma. Acta Neuropathol.120(4), 529–535 (2010).
  • Nakamura M, Sakaki T, Hashimoto H et al. Frequent alterations of the p14(ARF) and p16(INK4a) genes in primary central nervous system lymphomas. Cancer Res.61(17), 6335–6339 (2001).
  • Harada K, Nishizaki T, Kubota H, Suzuki M, Sasaki K. Distinct primary central nervous system lymphoma defined by comparative genomic hybridization and laser scanning cytometry. Cancer Genet. Cytogenet.125(2), 147–150 (2001).
  • Rubenstein JL, Fridlyand J, Shen A et al. Gene expression and angiotropism in primary CNS lymphoma. Blood107(9), 3716–3723 (2006).
  • Tun HW, Personett D, Baskerville KA et al. Pathway analysis of primary central nervous system lymphoma. Blood111(6), 3200–3210 (2008).
  • El-Tanani MK, Campbell FC, Kurisetty V, Jin D, McCann M, Rudland PS. The regulation and role of osteopontin in malignant transformation and cancer. Cytokine Growth Factor Rev.17(6), 463–474 (2006).
  • Riemersma SA, Jordanova ES, Schop RF et al. Extensive genetic alterations of the HLA region, including homozygous deletions of HLA class II genes in B-cell lymphomas arising in immune-privileged sites. Blood96(10), 3569–3577 (2000).
  • McCann KJ, Ashton-Key M, Smith K, Stevenson FK, Ottensmeier CH. Primary central nervous system lymphoma: tumor-related clones exist in the blood and bone marrow with evidence for separate development. Blood113(19), 4677–4680 (2009).
  • Riemersma SA, Oudejans JJ, Vonk MJ et al. High numbers of tumour-infiltrating activated cytotoxic T lymphocytes, and frequent loss of HLA class I and II expression, are features of aggressive B-cell lymphomas of the brain and testis. J. Pathol.206(3), 328–336 (2005).
  • Courts C, Montesinos-Rongen M, Brunn A et al. Recurrent inactivation of the PRDM1 gene in primary central nervous system lymphoma. J. Neuropathol. Exp. Neurol.67(7), 720–727 (2008).
  • Linnebank M, Schmidt S, Kolsch H et al. The methionine synthase polymorphism D919G alters susceptibility to primary central nervous system lymphoma. Br. J. Cancer90(10), 1969–1971 (2004).
  • Ferreri AJ, Dell’Oro S, Capello D et al. Aberrant methylation in the promoter region of the reduced folate carrier gene is a potential mechanism of resistance to methotrexate in primary central nervous system lymphomas. Br. J. Haematol.126(5), 657–664 (2004).
  • Kurzwelly D, Glas M, Roth P et al. Primary CNS lymphoma in the elderly: temozolomide therapy and MGMT status. J. Neurooncol.97(3), 389–392 (2010).
  • Takeuchi H, Matsuda K, Kitai R, Sato K, Kubota T. Angiogenesis in primary central nervous system lymphoma (PCNSL). J. Neurooncol.84(2), 141–145 (2007).
  • Cote TR, Manns A, Hardy CR, Yellin FJ, Hartge P. Epidemiology of brain lymphoma among people with or without acquired immunodeficiency syndrome. AIDS/Cancer Study Group. J. Natl Cancer Inst.88(10), 675–679 (1996).
  • Mrugala MM, Rubenstein JL, Ponzoni M, Batchelor TT. Insights into the biology of primary central nervous system lymphoma. Curr. Oncol. Rep.11(1), 73–80 (2009).
  • Chan CC, Rubenstein JL, Coupland SE et al. Primary vitreoretinal lymphoma: a report from an International Primary Central Nervous System Lymphoma Collaborative Group symposium. Oncologist16(11), 1589–1599 (2011).
  • Buehring U, Herrlinger U, Krings T, Thiex R, Weller M, Kuker W. MRI features of primary central nervous system lymphomas at presentation. Neurology57(3), 393–396 (2001).
  • Shibamoto Y, Ogino H, Suzuki G et al. Primary central nervous system lymphoma in Japan: changes in clinical features, treatment, and prognosis during 1985–2004. Neuro Oncol.10(4), 560–568 (2008).
  • Kawai N, Okubo S, Miyake K et al. Use of PET in the diagnosis of primary CNS lymphoma in patients with atypical MR findings. Ann. Nucl. Med.24(5), 335–343 (2010).
  • Kawase Y, Yamamoto Y, Kameyama R, Kawai N, Kudomi N, Nishiyama Y. Comparison of 11C-methionine PET and 18F-FDG PET in patients with primary central nervous system lymphoma. Mol. Imaging Biol.13(6), 1284–1289 (2011).
  • Hollender A, Kvaloy S, Nome O, Skovlund E, Lote K, Holte H. Central nervous system involvement following diagnosis of non-Hodgkin’s lymphoma: a risk model. Ann. Oncol.13(7), 1099–1107 (2002).
  • Ferreri AJ, Reni M, Zoldan MC, Terreni MR, Villa E. Importance of complete staging in non-Hodgkin’s lymphoma presenting as a cerebral mass lesion. Cancer77(5), 827–833 (1996).
  • Abrey LE, Batchelor TT, Ferreri AJ et al. Report of an international workshop to standardize baseline evaluation and response criteria for primary CNS lymphoma. J. Clin. Oncol.23(22), 5034–5043 (2005).
  • Mohile NA, Deangelis LM, Abrey LE. The utility of body FDG PET in staging primary central nervous system lymphoma. Neuro Oncol.10(2), 223–228 (2008).
  • Gonzales JA, Chan CC. Biopsy techniques and yields in diagnosing primary intraocular lymphoma. Int. Ophthalmol.27(4), 241–250 (2007).
  • Merle-Beral H, Davi F, Cassoux N et al. Biological diagnosis of primary intraocular lymphoma. Br. J. Haematol.124(4), 469–473 (2004).
  • Schroers R, Baraniskin A, Heute C et al. Diagnosis of leptomeningeal disease in diffuse large B-cell lymphomas of the central nervous system by flow cytometry and cytopathology. Eur. J. Haematol.85(6), 520–528 (2010).
  • Fischer L, Martus P, Weller M et al. Meningeal dissemination in primary CNS lymphoma: prospective evaluation of 282 patients. Neurology71(14), 1102–1108 (2008).
  • Jahnke K, Hummel M, Korfel A et al. Detection of subclinical systemic disease in primary CNS lymphoma by polymerase chain reaction of the rearranged immunoglobulin heavy-chain genes. J. Clin. Oncol.24(29), 4754–4757 (2006).
  • Corry J, Smith JG, Wirth A, Quong G, Liew KH. Primary central nervous system lymphoma: age and performance status are more important than treatment modality. Int. J. Radiat. Oncol. Biol. Phys.41(3), 615–620 (1998).
  • Abrey LE, Ben-Porat L, Panageas KS et al. Primary central nervous system lymphoma: the Memorial Sloan–Kettering Cancer Center prognostic model. J. Clin. Oncol.24(36), 5711–5715 (2006).
  • Ferreri AJ, Blay JY, Reni M et al. Prognostic scoring system for primary CNS lymphomas: the International Extranodal Lymphoma Study Group experience. J. Clin. Oncol.21(2), 266–272 (2003).
  • Hans CP, Weisenburger DD, Greiner TC et al. Confirmation of the molecular classification of diffuse large B-cell lymphoma by immunohistochemistry using a tissue microarray. Blood103(1), 275–282 (2004).
  • Braaten KM, Betensky RA, de Leval L et al. BCL-6 expression predicts improved survival in patients with primary central nervous system lymphoma. Clin. Cancer Res.9(3), 1063–1069 (2003).
  • Lin CH, Kuo KT, Chuang SS et al. Comparison of the expression and prognostic significance of differentiation markers between diffuse large B-cell lymphoma of central nervous system origin and peripheral nodal origin. Clin. Cancer Res.12(4), 1152–1156 (2006).
  • Levy O, Deangelis LM, Filippa DA, Panageas KS, Abrey LE. BCL-6 predicts improved prognosis in primary central nervous system lymphoma. Cancer112(1), 151–156 (2008).
  • Mathew BS, Carson KA, Grossman SA. Initial response to glucocorticoids. Cancer106(2), 383–387 (2006).
  • Pels H, Juergens A, Schirgens I et al. Early complete response during chemotherapy predicts favorable outcome in patients with primary CNS lymphoma. Neuro Oncol.12(7), 720–724 (2010).
  • Bellinzona M, Roser F, Ostertag H, Gaab RM, Saini M. Surgical removal of primary central nervous system lymphomas (PCNSL) presenting as space occupying lesions: a series of 33 cases. Eur. J. Surg. Oncol.31(1), 100–105 (2005).
  • Porter AB, Giannini C, Kaufmann T et al. Primary central nervous system lymphoma can be histologically diagnosed after previous corticosteroid use: a pilot study to determine whether corticosteroids prevent the diagnosis of primary central nervous system lymphoma. Ann. Neurol.63(5), 662–667 (2008).
  • Roth P, Wick W, Weller M. Steroids in neurooncology: actions, indications, side-effects. Curr. Opin. Neurol.23(6), 597–602 (2010).
  • Nelson DF. Radiotherapy in the treatment of primary central nervous system lymphoma (PCNSL). J. Neurooncol.43(3), 241–247 (1999).
  • Nelson DF, Martz KL, 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.23(1), 9–17 (1992).
  • Shibamoto Y, Ogino H, Hasegawa M et al. Results of radiation monotherapy for primary central nervous system lymphoma in the 1990s. Int. J. Radiat. Oncol. Biol. Phys.62(3), 809–813 (2005).
  • Correa DD, Shi W, Abrey LE et al. Cognitive functions in primary CNS lymphoma after single or combined modality regimens. Neuro Oncol.14(1), 101–108 (2011).
  • Blay JY, Bouhour D, Carrie C et al. The C5R protocol: a regimen of high-dose chemotherapy and radiotherapy in primary cerebral non-Hodgkin’s lymphoma of patients with no known cause of immunosuppression. Blood86(8), 2922–2929 (1995).
  • Abrey LE, Yahalom J, DeAngelis LM. Treatment for primary CNS lymphoma: the next step. J. Clin. Oncol.18(17), 3144–3150 (2000).
  • Bessell EM, Lopez-Guillermo A, Villa S et al. Importance of radiotherapy in the outcome of patients with primary CNS lymphoma: an analysis of the CHOD/BVAM regimen followed by two different radiotherapy treatments. J. Clin. Oncol.20(1), 231–236 (2002).
  • DeAngelis LM, Seiferheld W, Schold SC, Fisher B, Schultz CJ. Combination chemotherapy and radiotherapy for primary central nervous system lymphoma: Radiation Therapy Oncology Group Study 93-10. J. Clin. Oncol.20(24), 4643–4648 (2002).
  • Poortmans PM, Kluin-Nelemans HC, 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.21(24), 4483–4488 (2003).
  • Ferreri AJ, Dell’Oro S, Foppoli M et al. MATILDE regimen followed by radiotherapy is an active strategy against primary CNS lymphomas. Neurology66(9), 1435–1438 (2006).
  • Shah GD, Yahalom J, Correa DD et al. Combined immunochemotherapy with reduced whole-brain radiotherapy for newly diagnosed primary CNS lymphoma. J. Clin. Oncol.25(30), 4730–4735 (2007).
  • Glass J, Shustik C, Hochberg FH, Cher L, Gruber ML. Therapy of primary central nervous system lymphoma with pre-irradiation methotrexate, cyclophosphamide, doxorubicin, vincristine, and dexamethasone (MCHOD). J. Neurooncol.30(3), 257–265 (1996).
  • Ferreri AJ, Guerra E, Regazzi M et al. Area under the curve of methotrexate and creatinine clearance are outcome-determining factors in primary CNS lymphomas. Br. J. Cancer90(2), 353–358 (2004).
  • Shapiro WR, Young DF, Mehta BM. Methotrexate: distribution in cerebrospinal fluid after intravenous, ventricular and lumbar injections. N. Engl. J. Med.293(4), 161–166 (1975).
  • Batchelor T, Carson K, O’Neill A et al. Treatment of primary CNS lymphoma with methotrexate and deferred radiotherapy: a report of NABTT 96-07. J. Clin. Oncol.21(6), 1044–1049 (2003).
  • Herrlinger U, Kuker W, Uhl M et al. NOA-03 trial of high-dose methotrexate in primary central nervous system lymphoma: final report. Ann. Neurol.57(6), 843–847 (2005).
  • Joerger M, Huitema AD, Krahenbuhl S et al. Methotrexate area under the curve is an important outcome predictor in patients with primary CNS lymphoma: a pharmacokinetic–pharmacodynamic analysis from the IELSG no. 20 trial. Br. J. Cancer102(4), 673–677 (2010).
  • Jahnke K, Korfel A, Martus P et al. High-dose methotrexate toxicity in elderly patients with primary central nervous system lymphoma. Ann. Oncol.16(3), 445–449 (2005).
  • Abrey LE. Advances in primary CNS lymphoma: randomized clinical trials of chemotherapy and whole-brain radiotherapy. Curr. Neurol. Neurosci. Rep.11(3), 243–245 (2011).
  • Angelov L, Doolittle ND, Kraemer DF et al. Blood–brain barrier disruption and intra-arterial methotrexate-based therapy for newly diagnosed primary CNS lymphoma: a multi-institutional experience. J. Clin. Oncol.27(21), 3503–3509 (2009).
  • Rubenstein JL, Combs D, Rosenberg J et al. Rituximab therapy for CNS lymphomas: targeting the leptomeningeal compartment. Blood101(2), 466–468 (2003).
  • Batchelor TT, Grossman SA, Mikkelsen T, Ye X, Desideri S, Lesser GJ. Rituximab monotherapy for patients with recurrent primary CNS lymphoma. Neurology76(10), 929–930 (2011).
  • Maza S, Kiewe P, Munz DL et al. First report on a prospective trial with yttrium-90-labeled ibritumomab tiuxetan (Zevalin) in primary CNS lymphoma. Neuro Oncol.11(4), 423–429 (2009).
  • Iwamoto FM, Schwartz J, Pandit-Taskar N et al. Study of radiolabeled indium-111 and yttrium-90 ibritumomab tiuxetan in primary central nervous system lymphoma. Cancer110(11), 2528–2534 (2007).
  • Voloschin AD, Betensky R, Wen PY, Hochberg F, Batchelor T. Topotecan as salvage therapy for relapsed or refractory primary central nervous system lymphoma. J. Neurooncol.86(2), 211–215 (2008).
  • Fischer L, Thiel E, Klasen HA et al. Prospective trial on topotecan salvage therapy in primary CNS lymphoma. Ann. Oncol.17(7), 1141–1145 (2006).
  • Reni M, Zaja F, Mason W et al. Temozolomide as salvage treatment in primary brain lymphomas. Br. J. Cancer96(6), 864–867 (2007).
  • Pels H, Schmidt-Wolf IG, Glasmacher A et al. Primary central nervous system lymphoma: results of a pilot and Phase II study of systemic and intraventricular chemotherapy with deferred radiotherapy. J. Clin. Oncol.21(24), 4489–4495 (2003).
  • 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.91(3), 299–305 (2009).
  • Khan RB, Shi W, Thaler HT, DeAngelis LM, Abrey LE. Is intrathecal methotrexate necessary in the treatment of primary CNS lymphoma? J. Neurooncol.58(2), 175–178 (2002).
  • Sierra Del Rio M, Ricard D, Houillier C et al. Prophylactic intrathecal chemotherapy in primary CNS lymphoma. J. Neurooncol.106(1), 143–146 (2012).
  • Rubenstein JL, 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.25(11), 1350–1356 (2007).
  • Benesch M, Urban C. Liposomal cytarabine for leukemic and lymphomatous meningitis: recent developments. Expert Opin. Pharmacother.9(2), 301–309 (2008).
  • Ostermann K, Pels H, Kowoll A, Kuhnhenn J, Schlegel U. Neurologic complications after intrathecal liposomal cytarabine in combination with systemic polychemotherapy in primary CNS lymphoma. J. Neurooncol.103(3), 635–640 (2011).
  • Gallego Perez-Larraya J, Palma JA, Carmona-Iragui M et al. Neurologic complications of intrathecal liposomal cytarabine administered prophylactically to patients with non-Hodgkin lymphoma. J. Neurooncol.103(3), 603–609 (2011).
  • Herrlinger U, Glantz M, Schlegel U, Gisselbrecht C, Cavalli F. Should intra-cerebrospinal fluid prophylaxis be part of initial therapy for patients with non-Hodgkin lymphoma: what we know, and how we can find out more. Semin. Oncol.36(4 Suppl. 2), S25–S34 (2009).
  • Ferreri AJ, Crocchiolo R, Assanelli A, Govi S, Reni M. High-dose chemotherapy supported by autologous stem cell transplantation in patients with primary central nervous system lymphoma: facts and opinions. Leuk. Lymphoma49(11), 2042–2047 (2008).
  • Soussain C, Suzan F, Hoang-Xuan K et al. Results of intensive chemotherapy followed by hematopoietic stem-cell rescue in 22 patients with refractory or recurrent primary CNS lymphoma or intraocular lymphoma. J. Clin. Oncol.19(3), 742–749 (2001).
  • Soussain C, Hoang-Xuan K, Taillandier L et al. Intensive chemotherapy followed by hematopoietic stem-cell rescue for refractory and recurrent primary CNS and intraocular lymphoma: Societe Francaise de Greffe de Moelle Osseuse-Therapie Cellulaire. J. Clin. Oncol.26(15), 2512–2518 (2008).
  • Illerhaus G, Marks R, Ihorst G et al. High-dose chemotherapy with autologous stem-cell transplantation and hyperfractionated radiotherapy as first-line treatment of primary CNS lymphoma. J. Clin. Oncol.24(24), 3865–3870 (2006).
  • Colombat P, Lemevel A, Bertrand P et al. High-dose chemotherapy with autologous stem cell transplantation as first-line therapy for primary CNS lymphoma in patients younger than 60 years: a multicenter Phase II study of the GOELAMS group. Bone Marrow Transplant.38(6), 417–420 (2006).
  • Kiefer T, Hirt C, Spath C et al. Long-term 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 Ostdeutsche Studiengruppe Hamatologie und Onkologie OSHO-53 Phase II study. Ann. Oncol. doi:10.1093/annonc/mdr553 (2011) (Epub ahead of print).
  • Alimohamed N, Daly A, Owen C, Duggan P, Stewart DA. Upfront thiotepa, busulfan, cyclophosphamide, and autologous stem cell transplantation for primary CNS lymphoma: a single centre experience. Leuk. Lymphoma doi:10.3109/10428194.2011.633250) (2011) (Epub ahead of print).
  • Abrey LE, Moskowitz CH, Mason WP 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-to-treat analysis. J. Clin. Oncol.21(22), 4151–4156 (2003).
  • Hottinger AF, DeAngelis LM, Yahalom J, Abrey LE. Salvage whole brain radiotherapy for recurrent or refractory primary CNS lymphoma. Neurology69(11), 1178–1182 (2007).
  • Nguyen PL, Chakravarti A, Finkelstein DM, Hochberg FH, Batchelor TT, Loeffler JS. Results of whole-brain radiation as salvage of methotrexate failure for immunocompetent patients with primary CNS lymphoma. J. Clin. Oncol.23(7), 1507–1513 (2005).
  • Plotkin SR, Betensky RA, Hochberg FH et al. Treatment of relapsed central nervous system lymphoma with high-dose methotrexate. Clin. Cancer Res.10(17), 5643–5646 (2004).
  • Weller M, Platten M, Roth P, Wick W. Geriatric neuro-oncology: from mythology to biology. Curr. Opin. Neurol.24(6), 599–604 (2011).
  • Villano JL, Koshy M, Shaikh H, Dolecek TA, McCarthy BJ. Age, gender, and racial differences in incidence and survival in primary CNS lymphoma. Br. J. Cancer105(9), 1414–1418 (2011).
  • Ng S, Rosenthal MA, Ashley D, Cher L. High-dose methotrexate for primary CNS lymphoma in the elderly. Neuro Oncol.2(1), 40–44 (2000).
  • Zhu JJ, Gerstner ER, Engler DA et al. High-dose methotrexate for elderly patients with primary CNS lymphoma. Neuro Oncol.11(2), 211–215 (2009).
  • Hoang-Xuan K, Taillandier L, Chinot O et al. Chemotherapy alone as initial treatment for primary CNS lymphoma in patients older than 60 years: a multicenter Phase II study (26952) of the European Organization for Research and Treatment of Cancer Brain Tumor Group. J. Clin. Oncol.21(14), 2726–2731 (2003).
  • Illerhaus G, Marks R, Muller F et al. High-dose methotrexate combined with procarbazine and CCNU for primary CNS lymphoma in the elderly: results of a prospective pilot and Phase II study. Ann. Oncol.20(2), 319–325 (2009).
  • Fritsch K, Kasenda B, Hader C et al. Immunochemotherapy with rituximab, methotrexate, procarbazine, and lomustine for primary CNS lymphoma (PCNSL) in the elderly. Ann. Oncol.22(9), 2080–2085 (2011).
  • Omuro AM, Taillandier L, Chinot O, Carnin C, Barrie M, Hoang-Xuan K. Temozolomide and methotrexate for primary central nervous system lymphoma in the elderly. J. Neurooncol.85(2), 207–211 (2007).
  • Fliessbach K, Rogowski S, Hoppe C et al. Computer-based assessment of cognitive functions in brain tumor patients. J. Neurooncol.100(3), 427–437 (2010).

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.