Primäre Lymphome des zentralen Nervensystems

Primäre ZNS-Lymphome sind Non-Hodgkin Lymphome des Gehirnparenchyms, der Meningen, und/oder des Rückenmarks mit fakultativer Beteiligung der Augen. Durch die Verfügbarkeit effektiver Chemotherapieprotokolle hat sich die Prognose dieser Tumoren insbesondere für jüngere Patienten in den letzten Jahrzehnten deutlich verbessert.

Kernaussagen

• Primäre ZNS-Lymphome (PZNSL) sind seltene maligne Tumoren des zentralen Nervensystems und überwiegend den diffus großzelligen B-Zell-Non-Hodgkin-Lymphomen zuzuordnen

• Die operative Entfernung des Tumors spielt keine Rolle.

• Die Strahlentherapie sollte in der Primärtherapie und im Rezidiv aufgrund neurotoxischer Spätfolgen wann immer möglich vermieden werden.

• Eine alleinige Chemotherapie basierend auf Hochdosis-Methotrexat (HDMTX) führt insbesondere bei jüngeren Patienten häufig zu Langzeitremissionen.

• Die Chemotherapie sollte aus einem Induktions- und einem Konsolidierungsteil bestehen.

• Im Rezidiv besteht keine etablierte Standardtherapie, jedoch stellen hier neue gezielte Therapieansätze, die in klinischen Studien geprüft werden, interessante Möglichkeiten dar.

Publication History

Article published online:
03 September 2021

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