How do you treat a young woman of child bearing age group diagnosed with primary CNS lymphoma?

The first step is to check HIV serology to ensure that the patient is HIV negative as HIV+ve patients would need to antiretroviral therapy promptly along with chemotherapy or the prognosis is dismal. If patient is young and fit the initial approach is similar in both HIV +ve and -ve patients. Assuming that the patient is HIV negative and has a normal GFR, high dose methotrexate (HD MTX) is the backbone of all chemotherapy in patients with PCNSL and HD MTX based regimens are associated with extended survival in at least 50% of patients. For a young fit patient, I usually recommend the "Ferreri regimen"; methotrexate 3.5 g/m(2) on day 1 plus cytarabine 2 g/m(2) twice a day on days 2-3 (Ferreri et al. Lancet. 2009 Oct 31;374(9700):1512-20) for...