Primary Central Nervous System Lymphoma

 

 

OVERVIEW

Primary central nervous system lymphoma is an aggressive non-Hodgkin's lymphoma that occurs when malignant cells arise in the lymphatic system of the brain and/or spine. Primary central nervous system lymphoma does not spread. It stays confined to the brain, spinal cord, their lining, and sometimes the inside of the eye. Primary central nervous system lymphoma most often affects patients with AIDS or other disorders of the immune system or patients taking immunosuppressive medications. It is usually highly malignant, but recent advances in chemotherapy have improved patients' progress.

Lymphomas account for about 5 percent of all cases of cancer in the United States. The lymphatic system is part of the body's immune system. It aids in the body's fight against disease and infection. The lymphatic system includes a network of thin tubes (lymphatic vessels) that branch into tissues throughout the body. Lymphatic vessels carry lymph, a colorless, watery fluid that contains infection-fighting white blood cells called lymphocytes.

Along this network of vessels are small, bean-shaped organs called lymph nodes, clusters of which are located in the abdomen, chest, groin, neck, and underarms. Lymph nodes make and store white blood cells that fight infection. Lymphoid tissue is found in many places in throughout the body, including lymph nodes, the thymus (a small gland found behind the chest bone and in front of the heart), the spleen (an organ on the left side of the abdomen next to the stomach), the tonsils and adenoids, in the bone marrow (blood-cell producing tissue inside the large bones), and scattered within other systems, including the digestive and respiratory systems.

At The Cancer Center at Hackensack University Medical Center, our chief of the Division of Lymphoma is internationally renowned for his research and skills in diagnosing, treating, and managing all types of lymphoma, including Hodgkin's disease and non-Hodgkin's lymphomas. Hematologist/oncologist Andre Goy, M.D., M.S., specializes in developing and investigating innovative new treatment advances for lymphoma, including stem cell transplantation, cellular therapy, immunotherapy, and novel targeted therapies that attack only the cancer cells and spare healthy tissue. Dr. Goy has trained and/or worked at some of the world's leading medical institutions, including Memorial Sloan-Kettering Cancer Center in New York City, the University of Texas' M.D. Anderson Cancer Center in Houston, University Hospital Group of Paris, France, and the Pasteur Institute in Paris.

A crucial component to the accurate diagnosis of lymphoma is The Cancer Center's Special Diagnostic Immunology Laboratory, one of only several sites in New Jersey where comprehensive tests are available to detect cancer at the molecular level and to stage and classify it.

The Cancer Center also features the following unique and innovative services for patients with primary central nervous system lymphoma:

  • board-certified  hematologist/oncologists, neuro-oncologists, neuro-radiologists, cytopathologists who are highly skilled in diagnosing, treating, and managing patients with lymphoma
  • a Tissue Bank, in collaboration with Stamford University, Conn., to study lymphoma at the molecular level using samples of blood, serum, and tissue that are collected from patients and then stored
  • one of the country's 10 largest stem cell transplantation services
  • a full range of diagnostic technology and imaging services to diagnose and monitor treatmen>, including the use of functional imaging, which helps to detect early resistance to chemotherapy. Treatment can be evaluated and adjusted if needed.
  • clinical trials to investigate new medications and treatment methods
  • a full range of support services

 

RISK FACTORS

People with compromised immune systems - such as patients with AIDS or other immune system disorders and those taking immunosuppressive medications - have an increased risk of developing primary central nervous system lymphoma. Genetic risk factors include a family history of brain and spinal cord tumors and inherited conditions such as neurofibromatosis (type 2), tuberous sclerosis, and von Hippel-Lindau disease.

 

SYMPTOMS

General symptoms for brain and spinal cord tumors include headaches, nausea or vomiting, weakness or numbness in arms or legs, trouble walking or uncoordinated walking, seizures or convulsions, changes in vision or unusual eye movements, drowsiness, changes in memory, and changes in speech.

 

TREATMENT SERVICES

The main treatment for primary central nervous system lymphoma is high-dose chemotherapy delivered intravenously (into the vein). In the past, intrathecal (placed directly into the fluid spaces of the brain) chemotherapy was used as the standard treatment, but high-dose intravenous chemotherapy has since been proven to be equally effective.