High-dose methotrexate plus temozolomide as a salvage treatment in metastatic central nervous system Lymphoma: two cases report and review of literature.

Temozolomide (TMZ), an alkylating agent, is widely used for treating high-grade gliomas and has emerged as a treatment option for primary central nervous system lymphoma (PCNSL) because of its good penetration of the blood-brain barrier (BBB) and mild toxicity profile. To our knowledge, the role of temozolomide in the treatment of lymphoma was confined to PCNSL and its role in lymphoma central infiltration has not been reported yet. We describe our experience using a combination of high-dose methotrexate and temozolomide (MT) in two metastatic central nervous system Lymphoma (CNSL). As far as we know, this is the first case report about temozolomide in metastatic CNSL patients and no study to date has incorporated investigation of the biology of metastatic CNSL into the treatment protocol. Temozolomide may represent a promising new drug for the treatment of metastatic CNSL.