A Single-Center Experience: Integrated Management in Primary Central Nervous System Lymphoma

The present study reports a single-center experience conducted at Józef Struś Multispecialty City Hospital in Poznań, Poland, in diagnosing and treating two patients with primary central nervous system lymphoma (PCNSL), one immunocompetent and one immunodeficient (AIDS). PCNSL is an extremely rare neoplasm with a poor prognosis and non-specific treatment on the basis of immunocompetency. Standard treatment consists of high-dose methotrexate (HD-MTX) being the background of a multimodal therapy, including other chemotherapeutic agents with and without radiation. To our knowledge, no alteration in management exists in immunocompromised individuals and so patients are subject to standard treatment options. Differences in patient management due to immunocompetency may necessitate separate protocols. The immunocompetent patient followed a more typical course, while the immunodeficient patient required balancing lymphoma treatment with the risks of opportunistic infections and drug interactions. These cases underscore the importance of tailored therapeutic approaches based on immune competency, aiming to improve outcomes for PCNSL.