Primary CNS lymphoma is a form of diffuse large B-cell lymphoma in which the central nervous system is the sole site of disease. CNS involvement by DLBCL is associated with a poor prognosis, and when the CNS is the primary location, a specific treatment approach is required.
This protocol addresses patients with primary central nervous system involvement by DLBCL — that is, disease confined to the CNS without involvement at other sites in the body.
Because of the blood-brain barrier, effective therapy must use agents capable of reaching CNS tissue at therapeutic concentrations.
Induction therapy relies on a high-dose regimen specifically chosen for its ability to penetrate the blood-brain barrier. After induction, a consolidation phase follows — with the specific consolidation approach depending on patient factors.
DOI: 10.1038/s41408-026-01458-2
Central nervous system (CNS) involvement by DLBCL is associated with a poor prognosis and can either be the only location of the disease (primary CNS lymphoma) or the CNS can be involved secondarily to disease at other sites in the body.
Induction therapy for primary CNS lymphoma relies on using high-dose methotrexate-based regimens that penetrate the blood-brain barrier.
This is followed by consolidation treatment such as an autologous stem cell transplant, maintenance methotrexate at a lower dose, or whole-brain radiation treatment.
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