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Diagnosis, prognosis and treatment of primary central nervous system lymphoma in the elderly population (Review)
Primary central nervous system lymphoma (PCNSL) is a rare subtype of extranodal non-Hodgkin lymphoma that is unique and different from systemic diffuse large B-cell lymphomas. The median age at diagnosis of PCNSL is 65 years and its incidence is rising rapidly in the elderly population. A total of ≥...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
D.A. Spandidos
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7864151/ https://www.ncbi.nlm.nih.gov/pubmed/33650642 http://dx.doi.org/10.3892/ijo.2021.5180 |
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author | Liu, Yanxia Yao, Qingmin Zhang, Feng |
author_facet | Liu, Yanxia Yao, Qingmin Zhang, Feng |
author_sort | Liu, Yanxia |
collection | PubMed |
description | Primary central nervous system lymphoma (PCNSL) is a rare subtype of extranodal non-Hodgkin lymphoma that is unique and different from systemic diffuse large B-cell lymphomas. The median age at diagnosis of PCNSL is 65 years and its incidence is rising rapidly in the elderly population. A total of ≥20% of all patients with PCNSL are ≥80 years old. Notably, age has been identified as an independent poor prognostic factor for PCNSL. Elderly patients have an inferior prognosis to that of younger patients and are more severely affected by iatrogenic toxicity; therefore, elderly patients represent a unique and vulnerable treatment subgroup. The present review summarized the available literature to provide an improved understanding of the epidemiology, clinical characteristics, diagnosis, prognosis and management of PCNSL in the elderly population. Notably, the incidence of PCNSL in immunocompetent elderly patients, predominantly in men, is increasing. For the diagnosis of CNSL, imaging-guided stereotactic biopsy is considered the gold standard. When stereotactic biopsy is not possible or conclusive, certain biomarkers have been described that can help establish a diagnosis. PCNSL has a very poor prognosis in the elderly, even though several prognostic scoring systems exist and several prognostic markers have been reported in patients with PCNSL. Furthermore, the treatment of elderly patients remains challenging; it is unlikely that a novel agent could be used as a curative monotherapy; however, a combination of novel agents with polychemotherapy or its combination with other novel drugs may have therapeutic potential. |
format | Online Article Text |
id | pubmed-7864151 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | D.A. Spandidos |
record_format | MEDLINE/PubMed |
spelling | pubmed-78641512021-02-27 Diagnosis, prognosis and treatment of primary central nervous system lymphoma in the elderly population (Review) Liu, Yanxia Yao, Qingmin Zhang, Feng Int J Oncol Articles Primary central nervous system lymphoma (PCNSL) is a rare subtype of extranodal non-Hodgkin lymphoma that is unique and different from systemic diffuse large B-cell lymphomas. The median age at diagnosis of PCNSL is 65 years and its incidence is rising rapidly in the elderly population. A total of ≥20% of all patients with PCNSL are ≥80 years old. Notably, age has been identified as an independent poor prognostic factor for PCNSL. Elderly patients have an inferior prognosis to that of younger patients and are more severely affected by iatrogenic toxicity; therefore, elderly patients represent a unique and vulnerable treatment subgroup. The present review summarized the available literature to provide an improved understanding of the epidemiology, clinical characteristics, diagnosis, prognosis and management of PCNSL in the elderly population. Notably, the incidence of PCNSL in immunocompetent elderly patients, predominantly in men, is increasing. For the diagnosis of CNSL, imaging-guided stereotactic biopsy is considered the gold standard. When stereotactic biopsy is not possible or conclusive, certain biomarkers have been described that can help establish a diagnosis. PCNSL has a very poor prognosis in the elderly, even though several prognostic scoring systems exist and several prognostic markers have been reported in patients with PCNSL. Furthermore, the treatment of elderly patients remains challenging; it is unlikely that a novel agent could be used as a curative monotherapy; however, a combination of novel agents with polychemotherapy or its combination with other novel drugs may have therapeutic potential. D.A. Spandidos 2021-02-01 /pmc/articles/PMC7864151/ /pubmed/33650642 http://dx.doi.org/10.3892/ijo.2021.5180 Text en Copyright: © Liu et al. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (https://creativecommons.org/licenses/by-nc-nd/4.0/) , which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. |
spellingShingle | Articles Liu, Yanxia Yao, Qingmin Zhang, Feng Diagnosis, prognosis and treatment of primary central nervous system lymphoma in the elderly population (Review) |
title | Diagnosis, prognosis and treatment of primary central nervous system lymphoma in the elderly population (Review) |
title_full | Diagnosis, prognosis and treatment of primary central nervous system lymphoma in the elderly population (Review) |
title_fullStr | Diagnosis, prognosis and treatment of primary central nervous system lymphoma in the elderly population (Review) |
title_full_unstemmed | Diagnosis, prognosis and treatment of primary central nervous system lymphoma in the elderly population (Review) |
title_short | Diagnosis, prognosis and treatment of primary central nervous system lymphoma in the elderly population (Review) |
title_sort | diagnosis, prognosis and treatment of primary central nervous system lymphoma in the elderly population (review) |
topic | Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7864151/ https://www.ncbi.nlm.nih.gov/pubmed/33650642 http://dx.doi.org/10.3892/ijo.2021.5180 |
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