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1. Nasir S, DeAngelis LM: Update on the management of primary CNS lymphoma. Oncology (Williston Park); 2000 Feb;14(2):228-34; discussion 237-42, 244

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Update on the management of primary CNS lymphoma.
  • Primary central nervous system (CNS) lymphoma is a non-Hodgkin's lymphoma restricted to the nervous system.
  • The incidence of this lymphoma is rising in the immunocompetent population but may be decreasing in patients with the acquired immune deficiency syndrome (AIDS) due to the introduction of highly active antiretroviral therapy.
  • A periventricular, diffusely enhancing lesion on magnetic resonance imaging (MRI) is suggestive of primary CNS lymphoma, but a stereotactic biopsy is needed to make a definitive diagnosis.
  • Concurrent leptomeningeal and ocular involvement is common in this brain tumor.
  • Because primary CNS lymphoma is exquisitely sensitive to steroids, these drugs should be withheld until tissue is obtained for diagnosis.
  • Age and performance status are important prognostic factors, regardless of specific treatment.
  • Methotrexate in high doses is the single most effective chemotherapeutic agent for primary CNS lymphoma.
  • It substantially improves survival when combined with radiation therapy and is better than radiotherapy alone as a single agent.
  • Multimodality treatment results in delayed cognitive neurotoxicity, particularly in older patients.
  • New treatment protocols have focused on the use of chemotherapy alone.
  • [MeSH-major] Central Nervous System Neoplasms / therapy. Lymphoma, Large B-Cell, Diffuse / therapy
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Combined Modality Therapy. Humans. Lymphoma, AIDS-Related / diagnosis. Lymphoma, AIDS-Related / therapy. Prognosis

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  • (PMID = 10736810.001).
  • [ISSN] 0890-9091
  • [Journal-full-title] Oncology (Williston Park, N.Y.)
  • [ISO-abbreviation] Oncology (Williston Park, N.Y.)
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 42
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2. Park BB, Kim JG, Sohn SK, Kang HJ, Lee SS, Eom HS, Kwon HC, Oh SY, Kang JH, Oh SJ, Shin HJ, Suh C, Kim JH, Kim HY, Kim K, Ryoo BY, Kim WS: Consideration of aggressive therapeutic strategies for primary testicular lymphoma. Am J Hematol; 2007 Sep;82(9):840-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Consideration of aggressive therapeutic strategies for primary testicular lymphoma.
  • To evaluate the clinical features and treatment of primary testicular lymphoma, 45 cases were retrospectively evaluated.
  • All patients underwent an orchiectomy, after which various treatments were given, chemotherapy alone in 37 patients (60%) and chemotherapy with involved field radiotherapy (IFRT) in 15 patients (33%).
  • Prophylactic intrathecal chemotherapy was given to six patients; cranial irradiation was given in two patients.
  • In six patients who received prophylactic intrathecal chemotherapy, there was no leptomeningeal progression, but brain parenchymal relapse occurred in two patients.
  • In conclusion, orchiectomy followed by intensive chemotherapy and IFRT including prophylaxis to the CNS and contralateral testis, should be considered as initial treatment in primary testicular lymphoma.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Lymphoma / drug therapy. Testicular Neoplasms / radiotherapy. Testicular Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Central Nervous System Neoplasms / secondary. Combined Modality Therapy. Cranial Irradiation. Disease Progression. Disease-Free Survival. Humans. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Recurrence, Local. Orchiectomy. Prognosis. Retrospective Studies. Time Factors. Treatment Failure. Treatment Outcome

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  • [Copyright] 2007 Wiley-Liss, Inc
  • (PMID = 17563078.001).
  • [ISSN] 0361-8609
  • [Journal-full-title] American journal of hematology
  • [ISO-abbreviation] Am. J. Hematol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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3. Rubenstein JL, Combs D, Rosenberg J, Levy A, McDermott M, Damon L, Ignoffo R, Aldape K, Shen A, Lee D, Grillo-Lopez A, Shuman MA: Rituximab therapy for CNS lymphomas: targeting the leptomeningeal compartment. Blood; 2003 Jan 15;101(2):466-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Rituximab therapy for CNS lymphomas: targeting the leptomeningeal compartment.
  • After intravenous administration, rituximab can be reproducibly measured in the cerebrospinal fluid (CSF) in patients with primary central nervous system lymphoma; however, the CSF levels of rituximab are approximately 0.1% of serum levels associated with therapeutic activity in patients with systemic non-Hodgkin lymphoma.
  • Because lymphomatous meningitis is a frequent complication of non-Hodgkin lymphoma, we have conducted an analysis of the safety and pharmacokinetics of direct intrathecal administration of rituximab using cynomolgus monkeys.
  • Pharmacokinetic analysis suggests that drug clearance from the CSF is biphasic, with a terminal half-life of 4.96 hours.
  • [MeSH-major] Antibodies, Monoclonal / administration & dosage. Antibodies, Monoclonal / pharmacokinetics. Central Nervous System Neoplasms / drug therapy. Lymphoma, Non-Hodgkin / drug therapy
  • [MeSH-minor] Animals. Antibodies, Monoclonal, Murine-Derived. Area Under Curve. Drug Evaluation, Preclinical. Female. Half-Life. Injections, Spinal. Macaca fascicularis. Metabolic Clearance Rate. Rituximab

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  • (PMID = 12393404.001).
  • [ISSN] 0006-4971
  • [Journal-full-title] Blood
  • [ISO-abbreviation] Blood
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 4F4X42SYQ6 / Rituximab
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4. Jun HJ, Kim WS, Yang JH, Yi SY, Ko YH, Lee J, Jung CW, Kang SW, Park K: Orbital infiltration as the first site of relapse of primary testicular T-cell lymphoma. Cancer Res Treat; 2007 Mar;39(1):40-3
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Orbital infiltration as the first site of relapse of primary testicular T-cell lymphoma.
  • The pathologic diagnosis of the radical orchiectomy specimen was peripheral T-cell lymphoma, unspecified (PTCL-u).
  • After first-line chemotherapy with four courses of the CHOP regimen and this was followed by involved-field radiotherapy, he achieved complete remission.
  • Although the patient received intensive chemotherapy with autologous hematopoietic stem cell transplantation, he ultimately died of leptomeningeal seeding.
  • Because both the central nervous system (CNS) and the orbit are sanctuary sites for chemotherapy, orbital infiltration of lymphoma should prompt physicians to evaluate involvement of the CNS and to consider performing prophylactic intrathecal chemotherapy as a treatment option.

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  • [Cites] Ophthalmology. 1999 Nov;106(11):2109-20 [10571346.001]
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  • (PMID = 19746228.001).
  • [ISSN] 1598-2998
  • [Journal-full-title] Cancer research and treatment : official journal of Korean Cancer Association
  • [ISO-abbreviation] Cancer Res Treat
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Korea (South)
  • [Other-IDs] NLM/ PMC2739356
  • [Keywords] NOTNLM ; Eye neoplasm / Non-Hodgkin's lymphoma / T cell lymphoma / Testes
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5. Taga T, Sakaue Y, Anzai Y, Takeuchi Y, Ohta S: Pediatric primary leptomeningeal lymphoma treated without cranial radiotherapy. Pediatr Blood Cancer; 2007 Apr;48(4):477-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Pediatric primary leptomeningeal lymphoma treated without cranial radiotherapy.
  • We report a case of primary leptomenigeal lymphoma (PLML) in an 11-year-old boy presenting with headache, vomiting, and diplopia.
  • The patient was treated on an advanced non-Hodgkin lymphoma protocol with systemic/intrathecal chemotherapy without cranial radiotherapy.
  • He remains in complete remission 33 months after treatment.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Lymphoma, Non-Hodgkin / drug therapy. Meningeal Neoplasms / drug therapy

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  • (PMID = 16411209.001).
  • [ISSN] 1545-5009
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antigens, CD; 0 / Biomarkers, Tumor; 04079A1RDZ / Cytarabine; 5J49Q6B70F / Vincristine; 7S5I7G3JQL / Dexamethasone; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; 9PHQ9Y1OLM / Prednisolone; D58G680W0G / pirarubicin; WI4X0X7BPJ / Hydrocortisone; YL5FZ2Y5U1 / Methotrexate
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6. George AC, Ozsahin M, Janzer R, Agassis S, Meuli R, Baur AS, Frossard V, Leyvraz S, Ketterer N: Primary intracranial dural lymphoma of mucosa-associated lymphoid tissue (MALT) type: report of one case and review of the literature. Bull Cancer; 2005 Jul;92(7):E51-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Primary intracranial dural lymphoma of mucosa-associated lymphoid tissue (MALT) type: report of one case and review of the literature.
  • Primary indolent leptomeningeal lymphoma is a rare entity, and corresponds in most cases to mucosa-associated lymphoid tissue (MALT) type lymphoma.
  • The biopsy revealed an infiltration of the dura by an indolent lymphoma, characteristic of a MALT-type lymphoma.
  • A treatment with systemic methotrexate, combined with intrathecal chemotherapy and followed by radiotherapy (30,6 Gy) of the primary site, was conducted.
  • The review of the literature highlights the importance to recognize the indolent PLML as a distinct clinical entity, which exhibits a rather good prognosis following a relatively non-toxic therapy.
  • [MeSH-major] Dura Mater. Lymphoma, B-Cell, Marginal Zone / pathology. Meningeal Neoplasms / pathology
  • [MeSH-minor] Aged. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy. Cytarabine / administration & dosage. Female. Humans. Hydrocortisone / administration & dosage. Methotrexate / administration & dosage

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  • (PMID = 16122999.001).
  • [ISSN] 1769-6917
  • [Journal-full-title] Bulletin du cancer
  • [ISO-abbreviation] Bull Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] France
  • [Chemical-registry-number] 04079A1RDZ / Cytarabine; WI4X0X7BPJ / Hydrocortisone; YL5FZ2Y5U1 / Methotrexate
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7. Kim HJ, Ha CK, Jeon BS: Primary leptomeningeal lymphoma with long-term survival: a case report. J Neurooncol; 2000 May;48(1):47-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Primary leptomeningeal lymphoma with long-term survival: a case report.
  • Primary leptomeningeal lymphoma (PLML) is a rare disease.
  • Chemotherapy and radiotherapy have been tried, but its prognosis is usually poor.
  • Initial diagnosis was made as idiopathic intracranial hypertension.
  • [MeSH-major] Lymphoma, B-Cell / mortality. Meningeal Neoplasms / mortality

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  • [Cites] Cancer. 1990 Oct 15;66(8):1856-60 [2170000.001]
  • [Cites] Cancer. 1983 Mar 15;51(6):1125-31 [6336987.001]
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  • (PMID = 11026696.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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8. Strik HM, Spreer A, Nagel H, Jacob S, Jung W, Kitze B, Bähr M: Clinical response following adjuvant Temozolomide in a patient with primary cerebral lymphoma. Anticancer Res; 2004 Nov-Dec;24(6):4121-5
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  • [Title] Clinical response following adjuvant Temozolomide in a patient with primary cerebral lymphoma.
  • A 69-year-old female patient was treated for primary CNS-lymphoma (PCNSL) starting from August 2002.
  • As her general condition allowed no high-dose methotrexate (MTX) therapy, radiotherapy was administered as a first-line treatment.
  • Therefore, oral chemotherapy with Temozolomide 200 mg/m2 was initiated.
  • We conclude that adjuvant Temozolomide chemotherapy can improve the general condition and cognition in patients with PCNSL even when the general condition is poor.
  • Long-term effects and neurotoxicity remain to be analysed in prospective trials, as well as the efficacy in leptomeningeal disease.
  • [MeSH-major] Antineoplastic Agents, Alkylating / therapeutic use. Brain Neoplasms / drug therapy. Dacarbazine / analogs & derivatives. Dacarbazine / therapeutic use. Lymphoma, Non-Hodgkin / drug therapy
  • [MeSH-minor] Administration, Oral. Aged. Chemotherapy, Adjuvant. Female. Humans

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  • (PMID = 15736462.001).
  • [ISSN] 0250-7005
  • [Journal-full-title] Anticancer research
  • [ISO-abbreviation] Anticancer Res.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Alkylating; 7GR28W0FJI / Dacarbazine; 85622-93-1 / temozolomide
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9. Shenkier TN: Unusual variants of primary central nervous system lymphoma. Hematol Oncol Clin North Am; 2005 Aug;19(4):651-64, vi
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Unusual variants of primary central nervous system lymphoma.
  • Rare variants of primary central nervous system lymphoma (PCNSL) include unusual sites of presentation (eg, neurolymphomatosis and primary leptomeningeal lymphoma) and uncommon pathologic entities.
  • Diagnosis requires a high index of suspicion, and treatment incorporates the principles of therapy for systemic and CNS lymphoma.
  • Primary leptomeningeal lymphoma can present with symptoms of raised intracranial pressure or cranial or spinal polyradiculopathies.
  • Diagnosis can be made by examining cerebrospinal fluid and incorporating immunophenotyping and molecular pathology techniques.
  • Treatment options include irradiation and intrathecal or systemic chemotherapy.
  • [MeSH-major] Central Nervous System Neoplasms / pathology. Lymphoma / pathology

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  • (PMID = 16083828.001).
  • [ISSN] 0889-8588
  • [Journal-full-title] Hematology/oncology clinics of North America
  • [ISO-abbreviation] Hematol. Oncol. Clin. North Am.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 39
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10. Pentheroudakis G, Pavlidis N: Management of leptomeningeal malignancy. Expert Opin Pharmacother; 2005 Jun;6(7):1115-25
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Management of leptomeningeal malignancy.
  • Leptomeningeal carcinomatosis is defined as malignant infiltration of the pia matter and arachnoid membrane.
  • Leukaemias and lymphomas, lung, breast cancer and melanoma are the primary tumours commonly associated with leptomeningeal carcinomatosis.
  • Diagnosis is based on compatible symptoms and signs, cytological evidence of malignancy in the cerebrospinal fluid, and neuroimaging studies.
  • Treatment is largely palliative (median survival 2-4 months).
  • Available treatment options include focal radiation therapy to CNS sites of bulky, symptomatic or obstructive meningeal deposits, intrathecal cytotoxic therapy and systemic chemotherapy.
  • No evidence of superiority of intrathecal treatment compared with best palliative care (including radiation therapy and systemic treatment) is available from clinical trials.
  • Novel treatment approaches include intrathecal liposomal Ara-C, the development of new cytotoxic compounds, signal transduction inhibitors and monoclonal antibodies for intrathecal or systemic use.
  • Until data from multi-centre randomised trials are available, rationalisation of therapy should be done by stratifying patients to prognostic groups.
  • High-risk patients will only survive for a few weeks and are better managed with supportive measures, whereas low-risk patients justify vigorous cerebrospinal fluid-directed treatment combined with radiation therapy and systemic chemotherapy.
  • [MeSH-major] Arachnoid Cysts / drug therapy. Carcinoma / drug therapy. Meningeal Neoplasms / drug therapy
  • [MeSH-minor] Adenocarcinoma / pathology. Algorithms. Antimetabolites, Antineoplastic / administration & dosage. Antimetabolites, Antineoplastic / cerebrospinal fluid. Antimetabolites, Antineoplastic / therapeutic use. Antineoplastic Agents, Alkylating / administration & dosage. Antineoplastic Agents, Alkylating / cerebrospinal fluid. Antineoplastic Agents, Alkylating / therapeutic use. Combined Modality Therapy. Cranial Irradiation. Cytarabine / administration & dosage. Cytarabine / cerebrospinal fluid. Cytarabine / therapeutic use. Delayed-Action Preparations. Enzyme Inhibitors / therapeutic use. Humans. Injections, Intravenous. Injections, Spinal. Leukemia / pathology. Lymphoma / pathology. Methotrexate / administration & dosage. Methotrexate / cerebrospinal fluid. Methotrexate / therapeutic use. Palliative Care. Randomized Controlled Trials as Topic. Thiotepa / administration & dosage. Thiotepa / cerebrospinal fluid. Thiotepa / therapeutic use. Topoisomerase I Inhibitors. Topotecan / therapeutic use

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  • (PMID = 15957966.001).
  • [ISSN] 1744-7666
  • [Journal-full-title] Expert opinion on pharmacotherapy
  • [ISO-abbreviation] Expert Opin Pharmacother
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; 0 / Antineoplastic Agents, Alkylating; 0 / Delayed-Action Preparations; 0 / Enzyme Inhibitors; 0 / Topoisomerase I Inhibitors; 04079A1RDZ / Cytarabine; 7M7YKX2N15 / Topotecan; 905Z5W3GKH / Thiotepa; YL5FZ2Y5U1 / Methotrexate
  • [Number-of-references] 43
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11. Aiello-Laws L, Rutledge DN: Management of adult patients receiving intraventricular chemotherapy for the treatment of leptomeningeal metastasis. Clin J Oncol Nurs; 2008 Jun;12(3):429-35
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  • [Title] Management of adult patients receiving intraventricular chemotherapy for the treatment of leptomeningeal metastasis.
  • Cancer in the central nervous system can arise from a primary brain tumor and metastasize to the brain or to the leptomeninges, leading to leptomeningeal metastasis (LM).
  • LM also is called leptomeningeal carcinomatosis and carcinomatous meningitis.
  • Nursing care of patients with LM requires an understanding of neurologic anatomy and physiology, along with associated treatments and complications.
  • Treatment of LM may involve intrathecal or, more likely, intraventricular chemotherapy.
  • The purpose of this article is to review the literature, summarize clinical care recommendations, and construct evidence-based guidelines for the administration of intraventricular chemotherapy and the care and monitoring of patients with LM.
  • [MeSH-major] Antimetabolites, Antineoplastic / therapeutic use. Cytarabine / therapeutic use. Injections, Intraventricular / nursing. Meningeal Neoplasms / drug therapy. Oncology Nursing / organization & administration
  • [MeSH-minor] Acquired Immunodeficiency Syndrome / complications. Adult. Blepharoptosis / etiology. Brain Neoplasms / pathology. Carcinoma / drug therapy. Carcinoma / nursing. Carcinoma / secondary. Drug Compounding. Drug Monitoring / nursing. Evidence-Based Medicine. Fatal Outcome. Humans. Low Back Pain / etiology. Lymphoma, AIDS-Related / complications. Male. Muscle Weakness / etiology. Nurse's Role. Nursing Assessment. Practice Guidelines as Topic

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  • (PMID = 18515241.001).
  • [ISSN] 1092-1095
  • [Journal-full-title] Clinical journal of oncology nursing
  • [ISO-abbreviation] Clin J Oncol Nurs
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; 04079A1RDZ / Cytarabine
  • [Number-of-references] 30
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12. Scrigni A, Nastri M, Rodríguez de Schiavi S, Czornyj L, Felice M, Mantese B: Leptomeningeal lymphoma in a child with acquired immune deficiency syndrome. Neuropediatrics; 2006 Jun;37(3):121-5
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  • [Title] Leptomeningeal lymphoma in a child with acquired immune deficiency syndrome.
  • Primary non-Hodgkin lymphoma of the central nervous system is rare in pediatric AIDS patients.
  • We report a seven-year-old HIV-infected boy, in stage C3 of the disease, who developed non-Hodgkin lymphoma in the central nervous system with a leptomeningeal location.
  • The diagnosis was based on brain biopsy, immunophenotypic studies of B cells, and Epstein-Barr virus serology of the cerebrospinal fluid.
  • The boy was treated with intrathecal and systemic chemotherapy.
  • Fifteen months after diagnosis he had clinically improved, but he then relapsed with a thalamic tumor.
  • In the present article, we discuss diagnostic difficulties, evolution, treatment, and the association of this neoplasm with the Epstein-Barr virus.
  • [MeSH-major] Acquired Immunodeficiency Syndrome / complications. Lymphoma, Non-Hodgkin / etiology. Meningeal Neoplasms / etiology


13. Plotkin SR, Batchelor TT: Primary nervous-system lymphoma. Lancet Oncol; 2001 Jun;2(6):354-65
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Primary nervous-system lymphoma.
  • Primary nervous-system lymphoma is a rare type of non-Hodgkin lymphoma, which is confined to the nervous system.
  • This disease is managed quite differently from the usual treatment of either primary brain tumours or systemic non-Hodgkin lymphoma.
  • Although whole-brain radiotherapy results in responses in more than 90% of cases, this treatment is associated with high relapse rates and with delayed neurotoxicity in elderly patients.
  • First-generation chemotherapy regimens used successfully in systemic non-Hodgkin lymphoma (eg cyclo-phosphamide, adriamycin, vincristine, and prednisone) are ineffective in primary nervous-system lymphoma, partly because of the blood-brain barrier.
  • Median survival of patients treated with radiotherapy alone or chemotherapy plus radiotherapy is similar, and ranges from 10 to 16 months.
  • The addition of methotrexate-based chemotherapy has improved survival for these patients, extending median survival to more than 30 months.
  • When used alone, methotrexate-based chemotherapy is associated with significantly fewer treatment-associated toxic effects.
  • Leptomeningeal lymphoma and intraocular lymphoma are topics of particular relevance in primary nervous-system lymphoma and are addressed in this review.
  • [MeSH-major] Lymphoma. Nervous System Neoplasms
  • [MeSH-minor] Age Factors. Aged. Combined Modality Therapy. Humans. Neoplasm Staging. Prognosis

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  • [ErratumIn] Lancet Oncol 2001 Jul;2(7):455
  • (PMID = 11905752.001).
  • [ISSN] 1470-2045
  • [Journal-full-title] The Lancet. Oncology
  • [ISO-abbreviation] Lancet Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] England
  • [Number-of-references] 73
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14. Weller M: [Chemotherapy for brain tumors in adult patients]. Nervenarzt; 2008 Feb;79(2):231-41
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  • [Title] [Chemotherapy for brain tumors in adult patients].
  • [Transliterated title] Chemotherapie von Hirntumoren bei Erwachsenen.
  • Chemotherapy has become a third major treatment option for patients with brain tumors, in addition to surgery and radiotherapy.
  • The role of chemotherapy in the treatment of gliomas is no longer limited to recurrent disease.
  • Several ongoing trials seek to define the role of chemotherapy in the primary care of other gliomas.
  • Outside such clinical trials chemotherapy is used in addition to radiotherapy, e.g., in anaplastic astrocytoma, medulloblastoma or germ cell tumors, or as an alternative to radiotherapy, e.g., in anaplastic oligodendroglial tumors or low-grade gliomas.
  • In contrast, there is no established role for chemotherapy in other tumors such as ependymomas, meningiomas or neurinomas.
  • Primary cerebral lymphomas are probably the only brain tumors which can be cured by chemotherapy alone and only by chemotherapy.
  • The chemotherapy of brain metastases follows the recommendations for the respective primary tumors.
  • Leptomeningeal metastases are treated by radiotherapy or systemic or intrathecal chemotherapy depending on their pattern of growth.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Brain Neoplasms / drug therapy. Glioma / drug therapy. Lymphoma / drug therapy
  • [MeSH-minor] Adult. Chemotherapy, Adjuvant. Chromosomes, Human, Pair 1. Chromosomes, Human, Pair 19. Combined Modality Therapy. DNA Methylation. DNA Modification Methylases / genetics. DNA Repair Enzymes / genetics. Dacarbazine / adverse effects. Dacarbazine / analogs & derivatives. Dacarbazine / therapeutic use. Genetic Markers / genetics. Humans. Prognosis. Promoter Regions, Genetic / genetics. Topotecan / adverse effects. Topotecan / therapeutic use. Tumor Suppressor Proteins / genetics

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  • (PMID = 18253773.001).
  • [ISSN] 0028-2804
  • [Journal-full-title] Der Nervenarzt
  • [ISO-abbreviation] Nervenarzt
  • [Language] ger
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Genetic Markers; 0 / Tumor Suppressor Proteins; 7GR28W0FJI / Dacarbazine; 7M7YKX2N15 / Topotecan; EC 2.1.1.- / DNA Modification Methylases; EC 2.1.1.63 / MGMT protein, human; EC 6.5.1.- / DNA Repair Enzymes; YF1K15M17Y / temozolomide
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15. Macnealy MW, Newton HB, McGregor JM, Bell SD, Ray Chaudhury A, Slone HW, Bourekas EC: Primary meningeal CNS lymphoma treated with intra-arterial chemotherapy and blood-brain barrier disruption. J Neurooncol; 2008 Dec;90(3):329-33
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  • [Title] Primary meningeal CNS lymphoma treated with intra-arterial chemotherapy and blood-brain barrier disruption.
  • Diffuse large B-cell lymphoma of the meninges is a particularly rare form of primary CNS lymphoma.
  • We report a case of a 63-year-old woman found to have primary meningeal lymphoma (PML) with dural and leptomeningeal involvement whom we treated with multiple cycles of intra-arterial (IA) methotrexate, intravenous (IV) etoposide phosphate, and IV cyclophosphamide after reversible osmotic blood-brain barrier disruption (BBBD).
  • Improvement was evident on gadolinium-enhanced brain MRI one month into therapy.
  • At 67 months post-diagnosis there is no evidence of CNS disease.
  • After completing her therapy regimen, she remained disease-free for 34 months, when stage IV diffuse large B-cell lymphoma was discovered in her left adrenal gland and right thigh.
  • Following six cycles of rituximab and CHOP treatment, she is presently in complete remission.
  • IA methotrexate and reversible osmotic BBBD without radiation therapy may be an effective therapy for treating PML.
  • [MeSH-major] Antineoplastic Agents / administration & dosage. Blood-Brain Barrier / drug effects. Central Nervous System Neoplasms / drug therapy. Enzyme Inhibitors / administration & dosage. Lymphoma, Large-Cell, Immunoblastic / drug therapy. Methotrexate / administration & dosage

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  • (PMID = 18758913.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Enzyme Inhibitors; 0 / Organophosphorus Compounds; 528XYJ8L1N / etoposide phosphate; 6PLQ3CP4P3 / Etoposide; YL5FZ2Y5U1 / Methotrexate
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16. Shapiro WR, Johanson CE, Boogerd W: Treatment modalities for leptomeningeal metastases. Semin Oncol; 2009 Aug;36(4 Suppl 2):S46-54
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  • [Title] Treatment modalities for leptomeningeal metastases.
  • Secondary involvement of the leptomeninges represents an infrequent but devastating (and nearly always fatal) complication of solid tumors, hematologic malignancies (both leukemia and lymphoma), and primary brain tumors.
  • Clinical suspicion of neoplastic meningitis (NM) may be raised by the appearance of multivariate neurological symptoms; however, a definitive diagnosis is often difficult to obtain.
  • Improved treatments for primary malignancies and advances in diagnostic imaging technology have led to an apparent increase in the number of patients diagnosed with NM.
  • Unfortunately, therapeutic options remain limited, particularly for patients with chemoresistant tumors.
  • Optimized treatment remains controversial and may rely upon a combination of chemotherapy (intrathecal and/or intravenous) and concurrent focal radiotherapy.
  • Clinical trial evidence is presented for the different treatment modalities.
  • In addition, the therapeutic potential of intra-CSF therapy for cancer prophylaxis is discussed.
  • Earlier diagnosis and more aggressive preventive treatment regimens may provide substantial increases in survival and favorably affect quality of life.
  • Additional data from large-scale, well-controlled trials are required to more accurately assess the efficacy of intra-CSF versus systemic treatment in NM.
  • Future treatment options using novel targets for intra-CSF therapy will be addressed as well.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Meningeal Carcinomatosis / drug therapy. Meningeal Carcinomatosis / secondary

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  • (PMID = 19660683.001).
  • [ISSN] 0093-7754
  • [Journal-full-title] Seminars in oncology
  • [ISO-abbreviation] Semin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 73
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17. Ahluwalia MS, Peereboom DM: Primary central nervous system lymphoma. Curr Treat Options Neurol; 2010 Jul;12(4):347-59
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  • [Title] Primary central nervous system lymphoma.
  • OPINION STATEMENT: Management goals for patients with primary central nervous system lymphoma (PCNSL) include long-term disease control, management of neurologic complications, and preservation of neurocognitive function.
  • Various treatment options can achieve several of these goals.
  • Chemotherapy as monotherapy or as combination therapy has emerged as the cornerstone of therapy for patients with newly diagnosed PCNSL.
  • Outside of a clinical trial, patients with newly diagnosed PCNSL should receive high-dose intravenous methotrexate (MTX) as a single agent or as part of a combination regimen with radiation therapy reserved for relapse.
  • The regimen should have an adequate MTX dose (>3 g/m(2)) to reach cytotoxic concentrations in the cerebrospinal fluid (CSF) to treat occult leptomeningeal disease (LMD).
  • Alternative modes of chemotherapy delivery for selected patients, preferably in the context of a clinical trial, include high-dose chemotherapy with autologous stem cell rescue and intra-arterial chemotherapy with blood-brain barrier disruption.
  • Whole brain radiation therapy (WBRT) in standard doses and fractionation carries an unacceptable rate of long-term neurocognitive toxicity.
  • Patients with ocular lymphoma at diagnosis should receive high-dose MTX as this drug can reach cytotoxic intravitreal concentrations.
  • Recurrence in the eyes is managed with intravitreal chemotherapy including MTX or rituximab or with radiation therapy.
  • The field of treatment (eyes vs whole brain) should be individualized.
  • Intrathecal (IT) MTX should be included in the treatment regimen for those patients with a positive CSF cytology, or in regimens in which lower doses of MTX are delivered over longer periods of time.
  • It is probably reasonable to withhold IT chemotherapy in those patients who have no detectable subarachnoid disease and who can receive higher doses of MTX (>3 g/m(2)) over shorter infusion periods (2-4 h).
  • Patients who develop leptomeningeal involvement despite high- dose MTX can be managed with IT chemotherapy such as liposomal cytarabine or MTX or even rituximab.
  • Areas of bulky or symptomatic LMD should probably be treated with radiation therapy as well.

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  • (PMID = 20842593.001).
  • [ISSN] 1534-3138
  • [Journal-full-title] Current treatment options in neurology
  • [ISO-abbreviation] Curr Treat Options Neurol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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18. Khan RB, Shi W, Thaler HT, DeAngelis LM, Abrey LE: Is intrathecal methotrexate necessary in the treatment of primary CNS lymphoma? J Neurooncol; 2002 Jun;58(2):175-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Is intrathecal methotrexate necessary in the treatment of primary CNS lymphoma?
  • Systemic high-dose methotrexate (HD-MTX) is the most effective chemotherapeutic agent in the treatment of primary central nervous system lymphoma (PCNSL).
  • Leptomeningeal involvement is common and intrathecal methotrexate (IT-MTX) is frequently used in combination with HD-MTX, but its benefits are not established.
  • [MeSH-major] Antimetabolites, Antineoplastic / administration & dosage. Central Nervous System Neoplasms / drug therapy. Lymphoma / drug therapy. Methotrexate / administration & dosage
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Case-Control Studies. Dose-Response Relationship, Drug. Female. Humans. Injections, Spinal. Male. Middle Aged. Nervous System / drug effects. Retrospective Studies. Survival Analysis. Treatment Outcome

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  • (PMID = 12164690.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; YL5FZ2Y5U1 / Methotrexate
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19. Jahnke K, Korfel A, O'Neill BP, Blay JY, Abrey LE, Martus P, Poortmans PM, Shenkier TN, Batchelor TT, Neuwelt EA, Raizer JJ, Schiff D, Pels H, Herrlinger U, Stein H, Thiel E: International study on low-grade primary central nervous system lymphoma. Ann Neurol; 2006 May;59(5):755-62
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] International study on low-grade primary central nervous system lymphoma.
  • OBJECTIVE: The aim of this study was to characterize the clinical presentation, course, and outcome of low-grade primary central nervous system lymphoma.
  • Involvement of a cerebral hemisphere or deeper brain structures was seen in 37 patients, only leptomeningeal involvement in 2 patients, and spinal cord disease in 1 patient.
  • Chemotherapy/radiotherapy was conducted in 15 patients, radiotherapy alone in 12, chemotherapy alone in 10, and tumor resection alone in 2, whereas 1 patient received no treatment.
  • INTERPRETATION: Low-grade primary central nervous system lymphoma differs from the high-grade subtype in its pathological, clinical, and radiological features.
  • It has a better long-term outcome than primary central nervous system lymphoma in general with age 60 years or older adversely affecting survival.
  • [MeSH-major] Central Nervous System Neoplasms / pathology. Lymphoma / pathology
  • [MeSH-minor] Age Factors. Aged. Brain / pathology. Combined Modality Therapy. Disease Progression. Female. Humans. International Cooperation. Magnetic Resonance Imaging. Male. Middle Aged. Retrospective Studies. Survival Analysis. Treatment Outcome

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  • [CommentIn] Ann Neurol. 2006 May;59(5):9A-10A [16634011.001]
  • (PMID = 16586496.001).
  • [ISSN] 0364-5134
  • [Journal-full-title] Annals of neurology
  • [ISO-abbreviation] Ann. Neurol.
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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20. Laskin JJ, Savage KJ, Voss N, Gascoyne RD, Connors JM: Primary paranasal sinus lymphoma: natural history and improved outcome with central nervous system chemoprophylaxis. Leuk Lymphoma; 2005 Dec;46(12):1721-7
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  • [Title] Primary paranasal sinus lymphoma: natural history and improved outcome with central nervous system chemoprophylaxis.
  • Non-Hodgkin's lymphoma of the paranasal sinus is an uncommon presentation of extranodal lymphoma.
  • Its natural history, treatment and prognosis have been infrequently characterized in the medical literature; however, a tendency to involve the central nervous system (CNS) has been noted.
  • In British Columbia (population 4 million), a central database for lymphomas has allowed us to accurately track cases of paranasal sinus lymphoma diagnosed since 1980.
  • A retrospective review was performed on the 44 patients who presented with primary paranasal sinus lymphoma (stage I or II) between 1980 and 1999.
  • Complete diagnostic and follow-up data including stage, treatment, response rates, sites of relapse and survival data were available for all patients.
  • The types of lymphoma found were: diffuse large B cell (including immunoblastic), n = 37 (84%); T/NK nasal type, n = 3 (8%); peripheral T cell, not otherwise classified, n = 2 (4%); and others, n = 2 (4%).
  • Beginning in May 1985, intrathecal chemotherapy was added to our standard treatment plan of multi-agent chemotherapy and local irradiation.
  • Before 1985, 2 of 5 patients developed leptomeningeal metastasis.
  • Following the institution of intrathecal chemotherapy, only 8% (3 of 39) of patients have developed CNS disease.
  • Primary paranasal sinus lymphoma is an uncommon presentation of lymphoma that carries the potential risk of spreading to the leptomeninges.
  • Treatment with combined modality chemotherapy and irradiation can cure many patients and the addition of intrathecal chemotherapy may reduce the risk of CNS relapse.
  • [MeSH-major] Chemoprevention. Lymphoma, Non-Hodgkin / physiopathology. Paranasal Sinus Neoplasms / physiopathology
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Central Nervous System Neoplasms / prevention & control. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Neoplasm Staging. Retrospective Studies. Survival Analysis. Survivors. Treatment Outcome

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  • (PMID = 16263574.001).
  • [ISSN] 1042-8194
  • [Journal-full-title] Leukemia & lymphoma
  • [ISO-abbreviation] Leuk. Lymphoma
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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21. Elder JB, Chen TC: Surgical interventions for primary central nervous system lymphoma. Neurosurg Focus; 2006;21(5):E13
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Surgical interventions for primary central nervous system lymphoma.
  • Early diagnosis is central to proper management of primary central nervous system lymphomas (PCNSLs).
  • Surgical intervention hinges on initial entertainment of a diagnosis of a PCNSL, based on acute neurological presentation and neuroimaging findings.
  • Unless there is an urgent need for surgical decompression, a biopsy to obtain a diagnosis of PCNSL is the first step in surgical management.
  • Repeated biopsy may be necessary in patients who have received preoperative steroid therapy.
  • Patients with PCNSL may also present with leptomeningeal involvement, resulting in the need for an Ommaya reservoir for intrathecal chemotherapy.
  • [MeSH-major] Brain Neoplasms / surgery. Lymphoma, B-Cell / surgery. Meningeal Neoplasms / surgery

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  • (PMID = 17134115.001).
  • [ISSN] 1092-0684
  • [Journal-full-title] Neurosurgical focus
  • [ISO-abbreviation] Neurosurg Focus
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Number-of-references] 26
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22. Kim YB, Chang SK, Yang WI, Hahn JS, Koom WS, Shim SJ, Park W, Lee KK, Suh CO, Kim GE: Primary NK/T cell lymphoma of the testis. A case report and review of the literature. Acta Haematol; 2003;109(2):95-100
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  • [Title] Primary NK/T cell lymphoma of the testis. A case report and review of the literature.
  • We report a case of aggressive 'nasal type' natural killer (NK)/T cell lymphoma initially presenting as a testicular tumor in a Korean man, which quickly took a fatal course by widespread dissemination.
  • Immunophenotyping by immunohistochemistry yielded surface markers consistent with NK/T cell lymphoma.
  • During involved-field irradiation and chemotherapy following radical orchiectomy, the tumor disseminated shortly to the skin and soft tissue of his anterior chest wall and central nervous system (CNS).
  • CNS involvement was interpreted as having a leptomeningeal seeding.
  • To the best of our knowledge, this is the 9th reported case of confirmed NK/T cell lymphoma arising from the testis.
  • Relevant literature is reviewed, and the clinicopathologic features, natural history, and treatment options for primary testicular NK/T cell lymphoma are discussed.
  • [MeSH-major] Killer Cells, Natural. Lymphoma, T-Cell / diagnosis. Testicular Neoplasms / diagnosis
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Central Nervous System / pathology. Cyclophosphamide / therapeutic use. Doxorubicin / therapeutic use. Fatal Outcome. Herpesvirus 4, Human / genetics. Humans. Immunohistochemistry. Immunophenotyping. In Situ Hybridization. Male. Methotrexate / therapeutic use. Middle Aged. Necrosis. Neoplasm Metastasis. Orchiectomy. Prednisone / therapeutic use. RNA, Viral / analysis. Radiotherapy. Recurrence. Skin / pathology. Thoracic Wall / pathology. Tomography, X-Ray Computed. Ultrasonography. Vincristine / therapeutic use

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  • [Copyright] Copyright 2003 S. Karger AG, Basel
  • (PMID = 12624494.001).
  • [ISSN] 0001-5792
  • [Journal-full-title] Acta haematologica
  • [ISO-abbreviation] Acta Haematol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / RNA, Viral; 5J49Q6B70F / Vincristine; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; VB0R961HZT / Prednisone; YL5FZ2Y5U1 / Methotrexate; CHOP protocol
  • [Number-of-references] 16
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23. Pels H, Schulz H, Manzke O, Hom E, Thall A, Engert A: Intraventricular and intravenous treatment of a patient with refractory primary CNS lymphoma using rituximab. J Neurooncol; 2002 Sep;59(3):213-6
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  • [Title] Intraventricular and intravenous treatment of a patient with refractory primary CNS lymphoma using rituximab.
  • The treatment of primary central nervous system lymphoma (PCNSL) with chemo- and radiotherapy is efficient in terms of tumor response.
  • However, time to tumor progression often is of short duration and leptomeningeal relapse is common.
  • After treatment with intravenous and intraventricular administration of the chimeric anti-CD20 monoclonal antibody rituximab, a total clearing of lymphoma cells in the cerebrospinal fluid (CSF) was achieved.
  • There was no change in the size of the parenchymal tumor mass but there was slight improvement of clinical symptoms after therapy.
  • Antibody levels in CSF were measured at 7 timepoints during and after the treatment period.
  • These data suggest that intraventicular treatment with rituximab is safe and feasible with a potential activity on leptomeningeal tumor manifestation.
  • [MeSH-major] Antibodies, Monoclonal / administration & dosage. Antineoplastic Agents / administration & dosage. Brain Neoplasms / drug therapy. Lymphoma, B-Cell / drug therapy
  • [MeSH-minor] Aged. Antibodies, Monoclonal, Murine-Derived. Antigens, CD20 / metabolism. Blood Circulation / immunology. Humans. Infusions, Intravenous. Injections, Intraventricular. Magnetic Resonance Imaging. Male. Neoplasm Recurrence, Local / drug therapy. Neoplasm Recurrence, Local / immunology. Remission Induction. Rituximab

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  • (PMID = 12241117.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 0 / Antigens, CD20; 0 / Antineoplastic Agents; 4F4X42SYQ6 / Rituximab
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24. Navarro JT, Vall-Llovera F, Mate JL, Morgades M, Feliu E, Ribera JM: Decrease in the frequency of meningeal involvement in AIDS-related systemic lymphoma in patients receiving HAART. Haematologica; 2008 Jan;93(1):149-50
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  • [Title] Decrease in the frequency of meningeal involvement in AIDS-related systemic lymphoma in patients receiving HAART.
  • We evaluated the frequency of primary central nervous system lymphoma and leptomeningeal involvement in systemic non-Hodgkin's lymphoma (NHL) in HIV-infected patients.
  • Those receiving highly active antiretroviral therapy (HAART) showed a decrease in leptomeningeal involvement in systemic NHL (0/30 vs. 12/87; p=0.023).
  • [MeSH-major] Acquired Immunodeficiency Syndrome / diagnosis. Acquired Immunodeficiency Syndrome / drug therapy. Antiretroviral Therapy, Highly Active. Lymphoma, AIDS-Related / diagnosis. Lymphoma, AIDS-Related / prevention & control. Meninges / pathology
  • [MeSH-minor] Adult. Disease Progression. Female. Humans. Male. Prognosis. Retrospective Studies. Time Factors

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  • (PMID = 18166804.001).
  • [ISSN] 1592-8721
  • [Journal-full-title] Haematologica
  • [ISO-abbreviation] Haematologica
  • [Language] eng
  • [Publication-type] Letter; Research Support, Non-U.S. Gov't
  • [Publication-country] Italy
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25. Bierman P, Giglio P: Diagnosis and treatment of central nervous system involvement in non-Hodgkin's lymphoma. Hematol Oncol Clin North Am; 2005 Aug;19(4):597-609, v
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Diagnosis and treatment of central nervous system involvement in non-Hodgkin's lymphoma.
  • The diagnosis of lymphoma of the central nervous system (CNS) has been facilitated by advances in neuroimaging and laboratory analysis of cerebrospinal fluid.
  • The most common form of central nervous system CNS involvement in non-Hodgkin's lymphoma (NHL) is leptomeningeal disease.
  • After a diagnosis is established, the use of intrathecal or systemic chemotherapy and radiotherapy can improve survival and palliate symptoms.
  • High-dose systemic chemotherapy with hematopoietic stem cell transplantation is an important treatment option at central nervous system relapse of NHL and for primary CNS lymphoma.
  • The prognosis for disease-free survival and cure is better for patients who have treatment of CNS disease before transplantation than for patients who have active central nervous system disease at the time of transplant.
  • [MeSH-major] Central Nervous System Neoplasms / diagnosis. Central Nervous System Neoplasms / therapy. Lymphoma, Non-Hodgkin / diagnosis. Lymphoma, Non-Hodgkin / therapy
  • [MeSH-minor] Combined Modality Therapy. Humans. Prognosis

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  • (PMID = 16083825.001).
  • [ISSN] 0889-8588
  • [Journal-full-title] Hematology/oncology clinics of North America
  • [ISO-abbreviation] Hematol. Oncol. Clin. North Am.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 44
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26. Schulz H, Pels H, Schmidt-Wolf I, Zeelen U, Germing U, Engert A: Intraventricular treatment of relapsed central nervous system lymphoma with the anti-CD20 antibody rituximab. Haematologica; 2004 Jun;89(6):753-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Intraventricular treatment of relapsed central nervous system lymphoma with the anti-CD20 antibody rituximab.
  • Most patients with primary central nervous system (CNS) lymphoma or systemic non-Hodgkin's lymphoma (NHL) involving the CNS relapse after an initial response to treatment, often presenting with leptomeningeal disease.
  • Since the majority of these lymphomas are B-cell neoplasms expressing the CD20 surface antigen treatment with the chimeric monoclonal antibody (Mab) rituximab might be a new therapeutic option.
  • Here, we report on 6 patients with relapsed CNS B-cell lymphoma who were treated with intraventricular or intrathecal applications of rituximab.
  • [MeSH-major] Antibodies, Monoclonal / administration & dosage. Central Nervous System Neoplasms / drug therapy. Lymphoma, Non-Hodgkin / drug therapy
  • [MeSH-minor] Adult. Aged. Antibodies, Monoclonal, Murine-Derived. Humans. Injections, Intraventricular. Meningeal Neoplasms / drug therapy. Rituximab

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  • (PMID = 15194546.001).
  • [ISSN] 1592-8721
  • [Journal-full-title] Haematologica
  • [ISO-abbreviation] Haematologica
  • [Language] eng
  • [Publication-type] Letter; Research Support, Non-U.S. Gov't
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 4F4X42SYQ6 / Rituximab
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27. Grupka NL, Seinfeld J, Ryder J, Lillehei KO, Kleinschmidt-Demasters BK: Secondary central nervous system involvement by follicular lymphoma: case report and review of the literature. Surg Neurol; 2006 Jun;65(6):590-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Secondary central nervous system involvement by follicular lymphoma: case report and review of the literature.
  • BACKGROUND: We report a patient with indolent stage IV follicular lymphoma, grade 1, initially successfully treated with chemotherapy, who later developed aggressive diffuse large B-cell lymphoma in the parieto-occipital lobe 8 years after initial presentation.
  • CASE DESCRIPTION: A 53-year-old man was diagnosed with stage IV follicular lymphoma, grade 1, in 1996.
  • Although initial chemotherapy was successful, he developed several recurrences of lymphoma over the following years.
  • The mass proved to be an aggressive diffuse large B-cell lymphoma, transformed from his previous follicular cell lymphoma, with retention of strong Bcl-2 and Bcl-6 immunoreactivity.
  • CONCLUSIONS: Parenchymal brain involvement, as opposed to dural or leptomeningeal, is a relatively uncommon pattern of spread to the CNS for systemic lymphomas.
  • More significantly, follicular lymphomas are one of the least frequent types of indolent lymphomas to develop clinically apparent, secondary CNS spread.
  • The presentation of an indolent follicular lymphoma with transformation to an aggressive diffuse large B-cell lymphoma within the brain parenchyma is rare.
  • [MeSH-major] Central Nervous System Neoplasms / secondary. Lymphoma, B-Cell / pathology. Lymphoma, Follicular / pathology. Occipital Lobe / pathology. Parietal Lobe / pathology
  • [MeSH-minor] Antigens, CD / immunology. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Humans. Immunohistochemistry. Male. Middle Aged. Neoplasm Staging. Neoplasms, Second Primary / pathology

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  • (PMID = 16720183.001).
  • [ISSN] 0090-3019
  • [Journal-full-title] Surgical neurology
  • [ISO-abbreviation] Surg Neurol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antigens, CD
  • [Number-of-references] 16
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28. Wang W, Kardosh A, Su YS, Schonthal AH, Chen TC: Efficacy of celecoxib in the treatment of CNS lymphomas: an in vivo model. Neurosurg Focus; 2006;21(5):E14
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Efficacy of celecoxib in the treatment of CNS lymphomas: an in vivo model.
  • OBJECT: The incidence of primary central nervous system lymphomas (PCNSLs) has increased over the past several decades.
  • Unfortunately, even with the most effective therapeutic regimen (that is, methotrexate with wholebrain radiation therapy), PCNSL recurs within a few years in more than half of the treated patients and is eventually fatal.
  • Because PCNSL usually occurs in older patients and in those with acquired immunodeficiency syndrome, combination treatments in which both chemo- and radiation therapy are used is often poorly tolerated and results in a significant reduction in the quality of life.
  • Recently, it has been demonstrated that the selective cyclooxygenase- 2 inhibitor celecoxib (Celebrex), can block the growth of lymphoma cells in vitro.
  • METHODS: To create an experimental animal model in vivo for the PCNSL study, the authors intracranially injected a human B-cell lymphoma cell line into nude mice.
  • Their data demonstrate that this experimental model is an excellent one for human PCNSL with brain and leptomeningeal involvement.
  • They also evaluated the feasibility of using celecoxib as a therapeutic agent in the treatment of PCNSL.
  • The treated animals demonstrated significantly prolonged survival times compared with the untreated animals.
  • CONCLUSIONS: Based on the authors' data, celecoxib may be a promising therapeutic agent for the treatment of PCNSL.
  • [MeSH-major] Burkitt Lymphoma / drug therapy. Central Nervous System Neoplasms / drug therapy. Cyclooxygenase Inhibitors / pharmacology. Lymphoma, Non-Hodgkin / drug therapy. Pyrazoles / pharmacology. Sulfonamides / pharmacology
  • [MeSH-minor] Animal Feed. Animals. Apoptosis / drug effects. Celecoxib. Cell Line, Tumor. Disease Models, Animal. Humans. Mice. Mice, Nude. Neoplasm Transplantation. Reproducibility of Results. Survival Rate

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  • (PMID = 17134116.001).
  • [ISSN] 1092-0684
  • [Journal-full-title] Neurosurgical focus
  • [ISO-abbreviation] Neurosurg Focus
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Cyclooxygenase Inhibitors; 0 / Pyrazoles; 0 / Sulfonamides; JCX84Q7J1L / Celecoxib
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29. Kellie SJ, Barbaric D, Koopmans P, Earl J, Carr DJ, de Graaf SS: Cerebrospinal fluid concentrations of vincristine after bolus intravenous dosing: a surrogate marker of brain penetration. Cancer; 2002 Mar 15;94(6):1815-20
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  • However, the incidence of VCR-related central nervous system (CNS) toxicity is comparatively low, suggesting that the blood-brain barrier may limit drug penetration into the brain parenchyma.
  • This study determined whether measurable concentrations of VCR could be detected in the cerebrospinal fluid (CSF), as a surrogate marker of brain parenchyma penetration, after bolus intravenous injection in children without primary CNS pathology.
  • METHODS: The authors studied 17 pediatric patients ages 2.5-14.1 years (median, 6.8 years) with acute lymphoblastic leukemia or non-Hodgkin lymphoma without evidence of leptomeningeal disease.
  • Paired VCR concentrations in both plasma and CSF were measured in each patient simultaneously at times ranging from 8 minutes to 146 minutes after the VCR injection.
  • These findings suggest that the penetration of VCR into the brain parenchyma of patients with a relatively intact blood-brain barrier is low and that VCR may have a limited role in the CNS-directed therapy of these patients.
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Female. Humans. Infant. Injections, Intravenous. Lymphoma, Non-Hodgkin / drug therapy. Male. Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy

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  • [Copyright] Copyright 2002 American Cancer Society.
  • (PMID = 11920545.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; 5J49Q6B70F / Vincristine
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30. Tentori L, Graziani G: Pharmacological strategies to increase the antitumor activity of methylating agents. Curr Med Chem; 2002 Jul;9(13):1285-301
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Pharmacological strategies to increase the antitumor activity of methylating agents.
  • Among methylating agents of clinical interest, temozolomide is a novel antitumor compound that has raised particular interest due to its acceptable safety profile and activity against tumors poorly responsive to conventional chemotherapy, such as malignant glioma and metastatic melanoma.
  • Moreover, the drug has recently shown promising antitumor activity in a patient affected by primary brain lymphoma and is currently under phase II clinical trials for leptomeningeal metastases from leukemia and lymphoma or for brain metastases from lung and breast cancers.
  • The antitumor activity of TMZ, that generates different types of methyl adducts (70% N7-methylguanine, 10% N3-methyladenine and 9% O6-methylguanine), has been mainly attributed to the formation of O6-methylguanine adducts.
  • This review will focus on the different pharmacological strategies aimed at overcoming tumor resistance to TMZ such as new formulations of the drug or dosing schedules, and combined treatments with other chemotherapeutic agents, modulators of DNA repair systems, or gene therapy.
  • [MeSH-minor] Animals. Antineoplastic Combined Chemotherapy Protocols / pharmacology. Cell Cycle / drug effects. Combined Modality Therapy. DNA Methylation / drug effects. DNA Repair / drug effects. Humans. Mice. O(6)-Methylguanine-DNA Methyltransferase / antagonists & inhibitors

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  • (PMID = 12052167.001).
  • [ISSN] 0929-8673
  • [Journal-full-title] Current medicinal chemistry
  • [ISO-abbreviation] Curr. Med. Chem.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Alkylating; 7GR28W0FJI / Dacarbazine; 85622-93-1 / temozolomide; EC 2.1.1.63 / O(6)-Methylguanine-DNA Methyltransferase
  • [Number-of-references] 196
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31. Rogers LR: Cerebrovascular complications in cancer patients. Neurol Clin; 2003 Feb;21(1):167-92
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Cancer treatments may also contribute to this coagulopathy, which usually, but not exclusively, occurs in the setting of advanced malignant disease.
  • Concurrent systemic thrombosis is present in many patients and is a useful clue to the diagnosis.
  • There is no established treatment for the thrombotic coagulopathy associated with cancer, but anticoagulation should be considered.
  • In leukemia and lymphoma, the coagulopathy is typically acute DIC that can lead to systemic and brain hemorrhages.
  • The diagnosis can be suspected by the clinical setting and by systemic thrombosis or hemorrhage.
  • Therapy of acute DIC is controversial and should be individualized for the clinical setting.
  • Cerebrovascular disorders can complicate metastatic or primary tumor in the brain, skull, dura, or leptomeninges.
  • The diagnosis of tumor-related infarction can usually be established by neuroimaging studies that show infarction and may show extracerebral sites of tumor.
  • CSF examination is useful in diagnosing leptomeningeal metastasis.
  • Primary or metastatic tumors in the brain or dura may hemorrhage, producing the initial clinical signs of the brain tumor or a change in chronic signs induced by the tumor.
  • The brain hemorrhage may require evacuation and the underlying tumor will usually require additional antineoplastic treatment.
  • Cerebral arterial or venous thrombosis is sometimes the result of cancer therapy.
  • The attribution of thrombosis to chemotherapy in many published cases is only speculative, because carefully conducted prospective studies that include investigation for other thrombotic causes are not available.
  • The best-known associations with thrombosis are L-asparaginase, which is typically used in the induction therapy of acute lymphocytic leukemia, and combination hormonal therapy and chemotherapy for breast cancer.
  • Radiation to the head and neck, typically administered for head and neck epithelial cancers or lymphoma, may result in delayed carotid atherosclerosis.
  • Small clinical series suggest that surgical treatment is equally effective as in nonirradiated carotid atherosclerosis.
  • Brain hemorrhages can result from chemotherapy effects on the hemostatic system or a microangiopathic anemia.
  • Opportunistic infections, especially fungal infections, can complicate cancer or its treatment.
  • A clinician can usually establish the cause of stroke in the cancer patient by performing a careful review of the clinical setting--including the type and extent of cancer and the type of antineoplastic therapy--in which the stroke occurred.
  • Systemic thrombosis, embolism, or hemorrhage can be a clue to the cause, and appropriate neuroimaging and coagulation studies to aid in the diagnosis are available.
  • Therapy may ameliorate symptoms or prevent further episodes.
  • The identification of one of these unusual stroke syndromes that leads to the diagnosis of an occult and treatable cancer can be particularly rewarding.

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  • (PMID = 12690649.001).
  • [ISSN] 0733-8619
  • [Journal-full-title] Neurologic clinics
  • [ISO-abbreviation] Neurol Clin
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 87
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