BRAIN and NERVE－神経研究の進歩66巻8号

2014年08月発行

特集 神経系の悪性リンパ腫update

中枢神経系の悪性リンパ腫：治療update

著者： 中牧剛¹

所属機関： ¹昭和大学医学部内科学講座血液内科学部門

ページ範囲：P.969 - P.979

文献概要

中枢神経系原発悪性リンパ腫（PCNSL）は，日本のリンパ系腫瘍の約1～2%を占める稀な疾患である。PCNSLは血液脳関門により隔てられたいわゆるchemotherapeutic sanctuariesに発生する。PCNSLに対する1つの標準療法はメトトレキサートおよびシタラビン大量療法で寛解導入後，全脳照射（WBRT）で地固め療法を行う化学放射線療法で，わが国でも約30～40%の症例で長期生存が得られるようになった。さらなる生命予後の改善とWBRTによる毒性の回避がPCNSL治療における現在の主要な課題である。自家幹細胞移植を併用しアルキル化薬などの投与量を増加させることや抗CD20抗体など分子標的治療の導入が，WBRTの毒性を回避する治療法として試みられている。

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