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Central Nervous System Relapse in T and NK cell Lymphomas

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Abstract

Purpose of Review

T and NK cell lymphomas are relatively rare and heterogeneous forms of non-Hodgkin lymphoma that are associated with high rates of mortality. Central nervous system relapse carries significant morbidity, though management is largely extrapolated from literature in B cell neoplasms. As such, outcomes for central nervous system involvement in T/NK cell lymphomas are dismal with no standard of care. In this review, we discuss the epidemiology of central nervous system relapse in T/NK cell lymphomas and critically analyze available literature regarding prophylaxis and treatment.

Recent Findings

Retrospective studies of central nervous system involvement in T/NK cell lymphomas have been limited by small sample sizes and heterogeneity of subtypes, though sites of extranodal involvement and disease subtypes are consistently reported as risk factors. Compelling evidence for the use of central nervous system–directed prophylactic therapy has not yet been established, though recent reports of central nervous system activity with novel agents may suggest promising therapeutic options.

Summary

The overall rarity of T and NK cell lymphomas has precluded adequate study of prophylaxis and treatment of central nervous system relapse. Collaborative efforts are needed to better define strategies to address CNS disease in T/NK cell lymphomas. These should involve the use of targeted agents, which may hold an advantage over traditional cytotoxic drugs.

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Data Availability

All data associated with this review are presented here or in the cited references.

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Acknowledgements

The authors would like to thank Dr. Jasmine Zain for the opportunity to contribute this review.

Funding

Rahul S. Bhansali is supported by the Hematopoiesis Training Program grant at the University of Pennsylvania (T32DK07780) from the National Institutes of Health (NIH).

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  1. Division of Hematology and Oncology, Department of Medicine, Hospital of the University of Pennsylvania, South Pavilion, 12th Floor, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA

    Eleanor P. Taranto, Stefan K. Barta & Rahul S. Bhansali

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Correspondence to Rahul S. Bhansali.

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Eleanor P. Taranto reports personal fees from the Curbsiders Internal Medicine Podcast, outside the submitted work; Rahul S. Bhansali reports personal fees from Alva10, outside the submitted work; Stefan K. Barta reports personal fees from Acrotech, Affimed, Daiichi Sankyo, Janssen, Seagen, and Kyowa Kirin, outside the submitted work.

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Taranto, E.P., Barta, S.K. & Bhansali, R.S. Central Nervous System Relapse in T and NK cell Lymphomas. Curr Hematol Malig Rep 18, 243–251 (2023). https://doi.org/10.1007/s11899-023-00710-x

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