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Glucocorticoid Treatment of Primary CNS Lymphoma

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Abstract

Glucocorticoid therapy may result in the rapid resolution of cerebral mass lesions in patients with primary CNS lymphoma. Since glucocorticoids will obscure the histological diagnosis of primary CNS lymphoma upon biopsy, steroids should be withheld if primary CNS lymphoma is a likely diagnosis by neuroradiological criteria. The lympholytic effect of glucocorticoids is mediated by cytoplasmic steroid receptors which are translocated to the nucleus and signal apoptosis. Glucocorticoid-induced apoptosis of lymphoid cells does not require wild-type p53 activity, seems not to depend on caspase activation, but is attenuated by the bcl-2 protooncogene product. Long-term glucocorticoid therapy of primary CNS lymphoma is not recommended because relapse is probably inevitable and because of the prominent side effects of long-term glucocorticoid treatment. Further, long-term glucocorticoid treatment is contraindicated in immunocompromised patients with primary CNS lymphoma.

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References

  1. Bamberger CM, Schulte HM, Chrousos GP: Molecular determinants of glucocorticoid receptor function and tissue sensitivity to glucocorticoids. Endocr Rev 17: 245––261, 1996

    PubMed  Google Scholar 

  2. Wyllie AH: Glucocorticoid-induced thymocyte apoptosis is associated with endogenous endonuclease activation. Nature 284: 555––556, 1980

    PubMed  Google Scholar 

  3. Lowe SW, Schmitt EM, Smith SW, Osborne BA, Jacks T: p53 is required for radiation-induced apoptosis in mouse thymocytes. Nature 362: 847––849, 1993

    Article  PubMed  Google Scholar 

  4. Smith KGC, Strasser A, Vaux DL: CrmaA expression in T lymphocytes of transgenic mice inhibits CD95 (Fas/ APO-1)-transduced apoptosis but does not cause lymphadenopathy or autoimmune disease. EMBO J 15: 5167––5176, 1996

    PubMed  Google Scholar 

  5. Geley S, Hartman BL, Kapelari K, Egle A, Villunger A, Heidacher D, Greil R, Auer B, Kofler R: The interleukin-1_-converting enzyme inhibitorCrmAprevents APO-1/Fas-but not glucocorticoid-induced poly(ADP-ribose) polymerase cleavage and apoptosis in lymphoblastic leukemia cells. FEBS Lett 402: 36––40, 1997

    PubMed  Google Scholar 

  6. Helmberg A, Auphan N, Caelles C, Karin M: Glucocorticoid-induced apoptosis of human leukemic cells is caused by the repressive function of the glucocorticoid receptor. EMBO J 14: 452––460, 1995

    PubMed  Google Scholar 

  7. Wisniewska M, Stanczyk M, Grzelakowska-Sztabert B, Kamiska B: Nuclear factor of activated T cells (NFAT) is a possible target for dexamethasone in thymocyte apoptosis. Cell Biol Int 21: 127––132, 1997

    PubMed  Google Scholar 

  8. Memon SA, Moreno MB, Petrak D, Zacharchuk CM: Bcl-2 blocks glucocorticoid-but not Fas-or activationinduced apoptosis in a T cell hybridoma. J Immunol 155: 4644––4652, 1995

    PubMed  Google Scholar 

  9. Miyashita T, Reed JC: Bcl-2 gene transfer increases relative resistance of S49.1 and WEHI7.2 lymphoid cells to cell death and DNA fragmentation induced by glucocorticoids and multiple chemotherapeutic drugs. Cancer Res 52: 5407––5411, 1992

    PubMed  Google Scholar 

  10. Geppert M, Ostertag CB, Seitz G, Kiessling M: Glucocorticoid therapy obscures the diagnosis of cerebral lymphoma. Acta Neuropathol 80: 629––634, 1990

    PubMed  Google Scholar 

  11. Jellinger KA, Paulus W: Primary central nervous system lymphomas-new pathological developments. J Neuro-Oncol 24: 33––36, 1995

    Google Scholar 

  12. Herrlinger U, Schabet M, Eichhorn M, Petersen D, Grote EH, Meyermann R, Dichgans J: Prolonged corticosteroidinduced remission in primary central nervous system lymphoma: report of a case and review of the literature. Eur Neurol 36: 241––243, 1996

    PubMed  Google Scholar 

  13. Pirotte B, Levivier M, Goldman S, Brucher JM, Brotchi J, Hildebrand J: Glucocorticoid-induced long-term remission in primary cerebral lymphoma: case report and reviewof the literature. J Neuro-Oncol 32: 63––69, 1997

    Google Scholar 

  14. DeAngelis LM, Yahalom J, Heinemann MH, Cirrincione C, Thaler HT, Krol G: Primary CNS lymphoma: combined treatment with chemotherapy and radiotherapy. Neurology 40: 80––86, 1990

    PubMed  Google Scholar 

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Weller, M. Glucocorticoid Treatment of Primary CNS Lymphoma. J Neurooncol 43, 237–239 (1999). https://doi.org/10.1023/A:1006254518848

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  • DOI: https://doi.org/10.1023/A:1006254518848

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