Primary Central Nervous System Non-Hodgkin's Lymphoma

Li Liu, MD
Last Modified: November 1, 2001

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Question
Dear OncoLink "Ask the Experts,"
I have been searching for information about Non-Hodgkin's Lymphoma of the Brain. I can't seem to locate any information anywhere on the Internet. According to the oncologist that is taking care of my brother-in-law, he has only heard of one other case. Please let me know where I might find the information.  
Thank you very much.
L


Answer
Li Liu, MD, Editorial Assistant for OncoLink, responds:

Dear L.
Thank you for your interest and question.

Primary central nervous system non-Hodgkin's lymphoma (PCNSL) was once an extremely rare neoplasm, approximately 800 new cases occur in the United States every year. However, there has been an increasing incidence of PCNSL in both immunocompromised and immunocompetent patients. The reason is not clearly understood. It is the most common brain tumor in patients with the acquired immunodeficiency syndrome (AIDS) and occurs in about 10% of this population when they survive longer than 4 years.

Standard therapy has been whole brain radiotherapy. However, unfortunately for your brother-in-law, it is a very aggressive malignant disease. The patients' outcome has been quite poor despite aggressive treatment. In non-AIDS patients, the addition of chemotherapy to brain radiotherapy has improved the prognosis with longer survival. However, in patients with AIDS, the addition of chemotherapy to brain radiotherapy has not shown to benefit the patients significantly. The prognostic factors are age, performance status, and CD4 count.

Different treatment options and results can be found in Dr. Vincent T. DeVita, Jr's book "Cancer-Principles & Practice of Oncology, 5th Edition, " page 2233-2240.