Understanding Secondary Central Nervous System (CNS) Lymphoma

Secondary CNS lymphoma happens when non-Hodgkin’s lymphoma spreads to the brain, spinal cord, or eyes. Its symptoms depend on the areas of the CNS that are affected. The outlook for people with this lymphoma is poor.

Secondary central nervous system (CNS) lymphoma is when non-Hodgkin’s lymphoma (NHL) spreads to the central nervous system (CNS). Overall secondary CNS lymphoma is rare, but when it does occur, it may be very serious.

Keep reading to learn more about secondary CNS lymphoma, including symptoms, diagnosis, and treatment.

Primary vs. secondary CNS lymphoma

CNS lymphoma can be either primary or secondary:

• Primary CNS lymphoma: In primary CNS lymphoma, the lymphoma has originated in the CNS.
• Secondary CNS lymphoma: In secondary CNS lymphoma, the lymphoma has spread to the CNS from another part of the body. When lymphoma spreads widely to other areas of the body, it’s called “systemic lymphoma.”

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Between 2% and 10% of people with NHL have CNS involvement. Secondary CNS lymphoma happens when NHL that had started in another area of your body spreads to the CNS. Affected areas may include your brain, spinal cord, and eyes.

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Secondary CNS lymphomas typically involve aggressive types of NHL. According to the Leukemia and Lymphoma Society, 90% of CNS lymphomas arise due to diffuse large B-cell lymphoma (DLBCL).

The remaining types of NHL related to CNS lymphoma include other aggressive types of NHL such as Burkitt’s lymphoma and lymphoblastic lymphoma , as well as some types of slow-growing (indolent) NHL.

If your condition has been diagnosed as NHL, your lymphoma treatment may include treatment to prevent it from spreading to your CNS. This treatment is called “CNS prophylaxis” and is used in people with aggressive NHL that are at a high risk of CNS involvement.

A 2018 study notes that secondary CNS lymphoma happens in less than 5% of aggressive NHLs and less than 1% of indolent NHLs when CNS prophylaxis is used.

Secondary CNS lymphoma can occur in up to 50% of some aggressive types of NHL when no CNS prophylaxis is given. Examples of such lymphomas include:

• Burkitt’s lymphoma
• lymphoblastic lymphoma
• AIDS-related lymphoma

Is secondary CNS lymphoma curable?

Secondary CNS lymphoma typically can’t be cured. Instead, treatment for this type of lymphoma aims to manage your symptoms, stop the lymphoma from progressing further, and prolong survival.