What are the indications of lumbar puncture in the diagnosis and treatment of malignant lymphoma?

1. Diagnosis of lymphoma with central nervous system involvement: Due to the blood-brain barrier between blood vessels and cerebrospinal fluid, most chemotherapy drugs that enter the body through veins cannot enter the brain, and intrathecal chemotherapy drugs are required to be injected.

2. Aggressive lymphoma: Lymphoblastic lymphoma, Burkitt lymphoma, blastic mantle cell lymphoma and other aggressive lymphomas have a very high risk of invading the central nervous system, so prophylactic intrathecal injection is required.

3. Some moderately aggressive lymphomas: the incidence of diffuse large B-cell lymphoma and peripheral T-cell lymphoma invading the central nervous system is about 6%. Lumbar puncture is recommended for the following patients: ① The lesions involve the breast, testis, and sinuses 2) Invading more than two extranodal lesions, with a high-risk IPI score or above; 3) Patients with double-hit and triple-hit.

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