Abstract
In this chapter, commonly used chemotherapy regimens for primary central nervous system (CNS) lymphoma are discussed in the context of an overall approach to the disease. In the newly diagnosed setting, the mainstay of treatment remains methotrexate-based chemotherapy. Several effective multiagent methotrexate-based regimens have reported interesting results, although randomized studies are few. In the United States, the most common regimens are rituximab, procarbazine, vincristine, and cytarabine (R-MPV-A) and rituximab, methotrexate, temozolomide, cytarabine, and etoposide (R-MT-EA). Myeloablative chemotherapy regimens, particularly thiotepa, busulfan, and cyclophosphamide (TBC) followed by stem-cell transplant (ASCT) have emerged as powerful consolidation tools, although the optimal timing remains to be determined. The different available regimens will be discussed, with emphasis on efficacy and relative risks and benefits.