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Written by expert consultants and clinical scientists currently practising in the UK, the BSH Guidelines provide up-to-date evidence-based guidance on the diagnosis and treatment of haematological diseases. Self accreditation Listen to two podcasts and earn one CPD point via self-accreditation Join our Guidelines Newsletter to be notified when new guidelines/good practice papers are published by going into your members account under MyBSH. Non members can email bshguidelines@b-s-h.org.uk to sign up for updates.
Episodes
Thursday Dec 08, 2022
Thursday Dec 08, 2022
- Synchronous CNS and systemic lymphoma at initial presentation (treatment-naïve; TN-SCNSL),
- CNS relapse without recurrent systemic lymphoma (relapsed isolated CNS lymphoma; RI-SCNSL).
- Relapsed concomitant systemic and CNS disease following treatment for systemic lymphoma (RC-SCNSL).
CNS lymphoma (CNSL) is associated with inferior outcomes, which may be attributed to several factors: poor CNS penetrance of chemotherapeutics, including RCHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisolone),1 impaired neurocognitive function and patient performance status (PS) contributing to increased treatment toxicity,2, 3 and recurrent genetic aberrations conferring treatment resistance.4-6 The rarity and heterogeneity of SCNSL also limits the evidence base for treatment recommendations, with poor outcomes potentially attributable at least in part to lack of optimised treatment protocols.
This good practice paper focuses on diffuse large B-cell lymphoma (DLBCL), the most common SCNSL subtype. It covers diagnostic and therapeutic aspects of care for the three SCNSL scenarios and multiply relapsed SCNSL. Treatment recommendations are framed by patient fitness and treatment intent.
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