scholarly journals Outcomes of Autologous Stem Cell Transplant Consolidation in Primary Central Nervous System Lymphoma: A Mayo Clinic Experience

2020 ◽  
Vol 26 (12) ◽  
pp. 2217-2222
Author(s):  
Arushi Khurana ◽  
Ivana N. Micallef ◽  
Betsy R. LaPlant ◽  
Brian Patrick O’Neill ◽  
Thomas M. Habermann ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Stem Cell ◽  
Mayo Clinic ◽  
Stem Cell Transplant ◽  
Central Nervous System Lymphoma ◽  
Autologous Stem Cell Transplant ◽  
Cell Transplant ◽  
Clinic Experience

scholarly journals Successful Management of Natalizumab-Associated Primary Central Nervous System Lymphoma through Autologous Stem Cell Transplant

2020 ◽  
Vol 28 (1) ◽  
pp. 203-208
Author(s):  
Karine Moineau-Vallée ◽  
Justine Rinfret ◽  
My Hanh Luu Hoai ◽  
Valérie St-Louis ◽  
France Berthelet ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Stem Cell ◽  
Stem Cell Transplant ◽  
Central Nervous System Lymphoma ◽  
High Dose ◽  
Cell Transplant ◽  
Blurred Vision ◽  
Hematopoietic Stem ◽  
Increased Risk

Natalizumab is used as a second-line treatment for multiple sclerosis (MS). Some reports have linked natalizumab to primary central nervous system lymphoma (PCNSL), although few have described its management. A 45-year-old woman with Balo’s Concentric Sclerosis presented dizziness, vertigo accompanied by dysarthria, weakness on the left side and blurred vision to the right eye after the fourth dose of natalizumab. Magnetic resonance imaging (MRI) and a brain biopsy confirmed the diagnosis of PCNSL. The patient received modified PCNSL chemotherapy (MATRix protocol) followed by high-dose chemotherapy (HDC) supported by an autologous hematopoietic stem cell transplant (ASCT) as a consolidation therapy. Thirty months later, she is still in complete remission of her PCNSL and MS. In this case, whole brain radiotherapy was excluded because it may be associated with an increased risk of neurotoxicity in MS. ASCT was preferred because it has been shown to prevent disability progression in less advanced MS stages. Our patient is the second to receive an ASCT in this context and this option of treatment should be the preferred if the patient is eligible.

scholarly journals Aggressive Central Nervous System Relapse after Autologous Stem Cell Transplant in Multiple Myeloma: Case Reports and Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Rui Bergantim ◽  
Juliana Bastos ◽  
Maria José Soares ◽  
Bruno Carvalho ◽  
Pedro Soares ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Multiple Myeloma ◽  
Nervous System ◽  
Stem Cell ◽  
Stem Cell Transplant ◽  
Systemic Disease ◽  
Autologous Stem Cell Transplant ◽  
Central Nervous System Relapse ◽  
Cell Transplant ◽  
Extramedullary Disease

Extramedullary disease is an aggressive presentation at diagnosis and relapse for multiple myeloma (MM) patients. Central nervous system (CNS) is a very rare manifestation of the extramedullary disease, accounting for less than 1% of MM on diagnosis and relapse. Neurological symptoms are unspecific and usually attributed to other causes. We present two patients with CNS-MM at relapse after autologous stem cell transplant highlighting the importance of clinical suspicion and interdisciplinarity at diagnostic workup as well as the need for intensive therapeutic options on such rare and aggressive cases. The presence of neurological abnormalities in anamnesis and physical examination on a patient with MM should always prompt to suspect of a CNS involvement, and active investigation must be undertaken. MRI is the standard radiological method to detect CNS-MM, with histopathological corroboration by stereotactic biopsy and CSF evaluation alongside. Treatment of CNS-MM should include two essential approaches—be able to cross the BBB and treat the systemic disease. There is no standard therapy for this extramedullary relapse, and a tailored and multiple therapy should be promptly started—intrathecal therapy, radiotherapy, and systemic therapy, including an immunomodulator.

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