This or similar regimens have become the standard for now, which we are working to improve. Those with these characteristics are less likely to respond to lymphoma treatment. Rather, as with most cancers, progress comes in small but, one hopes, continuous steps. It is very frustrating to me that we have no effective treatment and thus cannot achieve remission in the primary CNS lymphomas. We can and do use radiation therapy, which does not prolong life much if at all but can make a big difference in quality of that life.
Patients wake up from comas or regain use of their muscles.
Progress has been slowed by the reluctance of physicians to study and treat primary CNS aggressively, believing such effort to be futile. However, a similar pessimism once stymied treatment of systemic lymphomas where we have made substantial progress, so I continually challenge my medical colleagues to rise above it here as well. One is B-4 blocked ricin, which is a genetically engineered substance based on a potent poison found naturally in some beans. Natural ricin contains an attachment site on its molecular surface which is capable of hooking up to any cell in the body after which the poison kills the cell. Preliminary results testing this compound in those for whom regular chemo failed, or resulted in relapse, have been very encouraging.