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Management of Primary Central Nervous System Diffuse Large B-Cell Lymphoma

ID: GL SCT-8 Oct 2017
Type of Content: Guidelines & Advice, Clinical
Document Status: Current
G. Fraser, N.P. Varela, J. Dudebout, J. Greenspoon, L. Hicks, N. Laperriere, A. Prica, T. Kouroukis, Primary Central Nervous System Lymphoma Guideline Development Group

Guideline Objective

To determine the most effective therapy for primary central nervous system diffuse large B-cell lymphoma (PCNS DLBCL) including primary intra-ocular lymphoma (PIOL).

Patient Population

Adult patients (≥18 years of age) with PCNS DLBCL including PIOL.

Intended Guideline Users

This guideline is intended for clinicians involved in the management of PCNS lymphoma in Ontario, and for policy makers and program planners involved in stem cell transplant and systemic and radiation therapy.

Research Questions

  1. What is/are the optimal chemotherapy regimen(s) for the first-line treatment of PCNS DLBCL?
  2. Does chemotherapy combined with radiation therapy improve the outcome of patients with PCNS DLBCL when compared with chemotherapy alone, and if so, what is the optimal radiation dose and schedule?
  3. Does HD-CT plus ASCT improve the outcome of patients with PCNS DLBCL when compared with standard-dose chemotherapy with or without radiation therapy in the:
    1. Front-line setting
    2. In the setting of relapsed/refractory disease
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