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.

中文翻译：

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T 细胞和 NK 细胞淋巴瘤的中枢神经系统复发

审查目的

T 细胞和 NK 细胞淋巴瘤是相对罕见且异质的非霍奇金淋巴瘤，与高死亡率相关。尽管治疗方法主要是根据 B 细胞肿瘤文献推断的，但中枢神经系统复发具有显着的发病率。因此，T/NK 细胞淋巴瘤中枢神经系统受累的结果在没有标准护理的情况下是令人沮丧的。在这篇综述中，我们讨论了 T/NK 细胞淋巴瘤中枢神经系统复发的流行病学，并严格分析了有关预防和治疗的现有文献。

最近的发现

尽管结外受累部位和疾病亚型一直被报告为危险因素，但 T/NK 细胞淋巴瘤中枢神经系统受累的回顾性研究受到样本量小和亚型异质性的限制。尽管最近有关新型药物对中枢神经系统活性的报道可能表明有希望的治疗选择，但尚未建立使用中枢神经系统定向预防性治疗的令人信服的证据。

概括

T 细胞和 NK 细胞淋巴瘤的总体罕见性阻碍了对中枢神经系统复发的预防和治疗的充分研究。需要共同努力来更好地制定治疗 T/NK 细胞淋巴瘤中枢神经系统疾病的策略。这些应该涉及使用靶向药物，这可能比传统的细胞毒性药物具有优势。