Research Projects

PCNsL is an aggressive form of non-Hodgkin's lymphoma that spreads beyond the lymph nodes and manifests in the spinal cord, brain, and leptomeninges. Isolated PCNsL has an incidence of 0-0.5 percent per 100,000 people per year. In around 15% of patients, there is associated leptomeningeal spread, and in 10% of patients, there is associated ocular involvement (vitreoretinal lymphoma). High morbidity and mortality are associated with PCNsL, the delayed diagnosis being one of the common causes. Diagnostic biomarkers available to clinicians to diagnose PCNsL at an early stage are almost negligible. Tools that clinicians use worldwide are neuroimaging, cerebrospinal fluid (CsF), vitreous analysis, Whole body Positron Emission tomography (PET), and biopsy. All these investigations have limited specificity and sensitivity, and most are either not available or of limited aid due to logistic issues. Brain biopsy is hence difficult to obtain. There is only limited western literature focused on CsF biomarkers for PCNsL and for DLBCL. There is an urgent need to identify biomarkers that are specific to PCNsL and are reflected in easily available fluids like serum/ CsF. Owing to the pathophysiological mechanisms, specific cytokines and chemokines are expressed in patients with lymphoma. Recent literature mentions the avid expression of these specific cytokines in body fluids like serum, vitreous, and CsF. This aspect can be extrapolated and incorporated for an early diagnosis of PCNsL. To the best of our knowledge, no Indian data is available on the same. Hence, the biomarkers need to be assessed to bring them into clinical use for PCNsL patients.