# Involvement of the central nervous system in relapsed T-cell lymphoma: insights from four case studies

## TL;DR

This paper discusses rare cases of T-cell lymphoma relapse in the central nervous system and the challenges in treating it.

## Contribution

The study provides insights into the management complexities and potential treatment strategies for CNS relapsed T-cell lymphoma.

## Key findings

- Four cases of CNS relapse in aggressive T-cell lymphomas were reported with poor survival rates.
- Patients showed resistance to standard treatments like intrathecal HD MTX and salvage chemotherapy.
- The study emphasizes the need for innovative, targeted therapies for CNS relapsed T-cell lymphoma.

## Abstract

CNS involvement in T-cell lymphoma is rare, with a 2–6 % risk of relapse. This report presents four cases of CNS relapse in aggressive T-cell lymphomas, including PTCL NOS, AITL, ALCL ALK (-), and ENKTCL. Patients experienced severe neurological symptoms, elevated CSF WBC counts, and resistance to various treatment regimens, including intrathecal HD MTX, salvage chemotherapy, and immunotherapy. Median survival was 1.5–3.5 months, highlighting the poor prognosis. The findings highlight the complexities of managing CNS relapse, the evolving understanding of prophylactic strategies, and the potential for innovative, targeted therapeutic combinations to enhance outcomes for these high-risk patients.