CNS Lymphoma Experts Discuss CSF Examination’s Current Uses, Limitations

Grzegorz Nowakowski, MD, of the Mayo Clinic, moderated a discussion on central nervous system (CNS) lymphoma with an expert panel, featuring Christian Grommes, MD, of the Memorial Sloan Kettering Cancer Center, Katherine Peters, MD, PhD, of the Preston Robert Tisch Brain Tumor Center, and Avyakta Kallam, MD, of the City of Hope Comprehensive Cancer Center.

The panel regards cerebrospinal fluid (CSF) examination to be an important part of CNS lymphoma clinical evaluation, though it can be challenging to perform. They surveyed a range of questions about how to use CSF findings, such as whether CSF involvement necessitates more aggressive management in patients and the degree to which mutations in CSF may differ from in the primary tumor.

A biomarker in CSF for CNS lymphoma is highly desirable for clinicians, but further research is needed to identify one. Dr. Grommes noted that such a biomarker would help avoid under or overtreatment in consolidation therapy. Dr. Peters, who feels discovery of such a biomarker is possible with current technology, said “if this ends up translating that we can prognosticate better for that rare population that may not need aggressive therapies, I think that’s really important.”