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Onkologie up2date 2021; 03(03): 253-265
DOI: 10.1055/a-1510-5709
Onkologische Hämatologie

Primäre Lymphome des zentralen Nervensystems

Uwe Schlegel
1   Mund-, Kiefer- u. Gesichtschirurgie, Knappschaftskrankenhaus, Bochum, Deutschland
,
Sabine Seidel
1   Mund-, Kiefer- u. Gesichtschirurgie, Knappschaftskrankenhaus, Bochum, Deutschland
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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

© 2021. Thieme. All rights reserved.

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