For people who have just been diagnosed with central nervous system (CNS) lymphoma, there are two phases of treatment: induction treatment, followed by consolidation treatment.
During induction treatment, chemotherapy is used to shrink the tumor or tumors. Several chemotherapy drugs may be used. A drug called rituximab (Rituxan®) is also part of treatment. This antibody drug is targeted to a protein that’s found on B cells, a type of immune cell that’s involved in lymphoma.
Consolidation treatment is used to prevent the cancer from coming back after induction. The treatment you get depends on your age and any other health conditions that you may have.
There are three approaches for consolidation treatment:
- additional chemotherapy
- high-dose chemotherapy followed by a blood or marrow stem cell transplant
- low-dose radiation therapy
Peripheral neuropathy is numbness or pain in the arms and legs. People with tumors causing peripheral neuropathy may also be given radiation therapy.
The leptomeninges are the spaces that surround the brain and spinal cord. They contain cerebrospinal fluid. People who have tumors in the leptomeninges may be given radiation therapy to reduce symptoms, too. People who have tumors in the brain or leptomeninges may also be given chemotherapy injected directly into the spine.
Surgery is generally not used to treat CNS lymphoma.
Treatment for CNS Lymphoma That’s More Difficult to Treat
After treatment for primary CNS lymphoma, about half of all people have their cancer come back. This usually happens within a year to 18 months, but it may come back five or more years later. Additionally, about 10 to 15 percent of people will not respond to initial induction therapy.
For these people, MSK offers a number of treatments. These treatments include additional chemotherapy, targeted therapy, or radiation therapy. Treatments depend on your age, the location in the body where the cancer is located, and how many times the cancer has come back.
MSK is conducting clinical trials to look at treatment options for people whose disease has returned after initial treatment.