CNS Lymphoma Pathway
Patients with suspected CNS lymphoma often face uncertainties and delays in the diagnostic pathway. This meeting aims to streamline the process, avoid unnecessary interventions like steroids pre-biopsy, and provide guidance for appropriate management. The advice from BNOG emphasizes the importance of a confirmed diagnosis before initiation of treatment. The solution proposed involves providing guidance through flow charts and contact details for proper management of patients.
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Presentation Transcript
CNS Lymphoma Pathway CNS Lymphoma Pathway Meeting Meeting Thursday 2ndFebruary 2023
Situation / Meeting Purpose: Situation / Meeting Purpose: Most commonly, patients with suspected CNS Lymphoma are referred to BNOG straight from emergency departments or local general medical teams BNOG offers a diagnostic service only for these patients; there are often uncertainties and delays in the patient pathway while the team try to establish if a biopsy is necessary/appropriate. The purpose of the meeting today is to determine how to optimise the pathway for patients and their significant others.
Advice from BNOG Advice from BNOG Steroids should not be started before the patient is referred for biopsy as this can make the lesion shrink and affect biopsy rates. In cases where this occurs, it is necessary to stop steroids and wait for the lesion to reappear, and many are slow to re-emerge.
Solution Solution Haematology teams cannot take ownership of this patient cohort until diagnosis has been confirmed to prevent overloading clinics with other neurological conditions, but advice and guidance on appropriate management at presentation can be provided in the form of a flow chart, as can contact details in each centre.
Meeting outputs Meeting outputs Guidelines will be drafted by Helen Dunderdale and Lorna Hawley prior to sending to the list of attendees and then Haem CAG for further ratification. Once finalised, the guidelines will be circulated to Medical Directors in each Trust to disseminate to general medical teams and emergency departments. Contacts details to be shared with BNOG (please put in chat box): Generic secretary emails Consultant Haematologist with a specialist interest in lymphoma.
