دورية أكاديمية
Recent updates on central nervous system prophylaxis in patients with high-risk diffuse large B-cell lymphoma
| العنوان: | Recent updates on central nervous system prophylaxis in patients with high-risk diffuse large B-cell lymphoma |
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| المؤلفون: | Bernard Ji Guang Chua, Chen Ee Low, Chun En Yau, Ya Hwee Tan, Jianbang Chiang, Esther Wei Yin Chang, Jason Yongsheng Chan, Eileen Yi Ling Poon, Nagavalli Somasundaram, Mohamed Farid Bin Harunal Rashid, Miriam Tao, Soon Thye Lim, Valerie Shiwen Yang |
| المصدر: | Experimental Hematology & Oncology, Vol 13, Iss 1, Pp 1-19 (2024) |
| بيانات النشر: | BMC, 2024. |
| سنة النشر: | 2024 |
| المجموعة: | LCC:Diseases of the blood and blood-forming organs LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens |
| مصطلحات موضوعية: | Diffuse Large B-Cell Lymphoma, Non-Hodgkin’s Lymphoma, Central Nervous System, CNS Prophylaxis, Methotrexate, Diseases of the blood and blood-forming organs, RC633-647.5, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282 |
| الوصف: | Abstract The use of central nervous system (CNS) prophylaxis for patients with diffuse large B-cell lymphoma (DLBCL) remains controversial. Although uncommon, CNS relapses are invariably fatal in this otherwise curable disease. Accurate identification of patients at risk and the optimal approach to CNS prophylaxis therefore remains an area of unmet need. The existing literature, largely retrospective in nature, provides mixed conclusions regarding the efficacy of CNS prophylaxis. The utility of CNS prophylaxis has itself been challenged. In this review, we dissect the issues which render the value of CNS prophylaxis uncertain. We first compare international clinical guidelines for CNS prophylaxis. We then interrogate the factors that should be used to identify high-risk patients accurately. We also explore how clinical patterns of CNS relapse have changed in the pre-rituximab and rituximab era. We then discuss the efficacy of CNS-directed approaches, intensification of systemic treatment and other novel approaches in CNS prophylaxis. Improved diagnostics for early detection of CNS relapses and newer therapeutics for CNS prophylaxis are areas of active investigation. In an area where prospective, randomized studies are impracticable and lacking, guidance for the use of CNS prophylaxis will depend on rigorous statistical review of retrospective data. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 2162-3619 |
| Relation: | https://doaj.org/toc/2162-3619 |
| DOI: | 10.1186/s40164-023-00467-2 |
| URL الوصول: | https://doaj.org/article/fa15e3df52d3405f9819bde075496542 |
| رقم الأكسشن: | edsdoj.fa15e3df52d3405f9819bde075496542 |
| قاعدة البيانات: | Directory of Open Access Journals |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 21623619 |
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| DOI: | 10.1186/s40164-023-00467-2 |