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Diagnosis, prognosis and treatment of primary central nervous system lymphoma in the elderly population (Review)

  • Authors:
    • Yanxia Liu
    • Qingmin Yao
    • Feng Zhang
  • View Affiliations / Copyright

    Affiliations: Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, P.R. China
  • Pages: 371-387
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    Published online on: February 1, 2021
       https://doi.org/10.3892/ijo.2021.5180
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Abstract

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.
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Copy and paste a formatted citation
Spandidos Publications style
Liu Y, Yao Q and Zhang F: Diagnosis, prognosis and treatment of primary central nervous system lymphoma in the elderly population (Review). Int J Oncol 58: 371-387, 2021.
APA
Liu, Y., Yao, Q., & Zhang, F. (2021). Diagnosis, prognosis and treatment of primary central nervous system lymphoma in the elderly population (Review). International Journal of Oncology, 58, 371-387. https://doi.org/10.3892/ijo.2021.5180
MLA
Liu, Y., Yao, Q., Zhang, F."Diagnosis, prognosis and treatment of primary central nervous system lymphoma in the elderly population (Review)". International Journal of Oncology 58.3 (2021): 371-387.
Chicago
Liu, Y., Yao, Q., Zhang, F."Diagnosis, prognosis and treatment of primary central nervous system lymphoma in the elderly population (Review)". International Journal of Oncology 58, no. 3 (2021): 371-387. https://doi.org/10.3892/ijo.2021.5180
Copy and paste a formatted citation
x
Spandidos Publications style
Liu Y, Yao Q and Zhang F: Diagnosis, prognosis and treatment of primary central nervous system lymphoma in the elderly population (Review). Int J Oncol 58: 371-387, 2021.
APA
Liu, Y., Yao, Q., & Zhang, F. (2021). Diagnosis, prognosis and treatment of primary central nervous system lymphoma in the elderly population (Review). International Journal of Oncology, 58, 371-387. https://doi.org/10.3892/ijo.2021.5180
MLA
Liu, Y., Yao, Q., Zhang, F."Diagnosis, prognosis and treatment of primary central nervous system lymphoma in the elderly population (Review)". International Journal of Oncology 58.3 (2021): 371-387.
Chicago
Liu, Y., Yao, Q., Zhang, F."Diagnosis, prognosis and treatment of primary central nervous system lymphoma in the elderly population (Review)". International Journal of Oncology 58, no. 3 (2021): 371-387. https://doi.org/10.3892/ijo.2021.5180
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