The following article features coverage from the 46th Annual Oncology Nursing Society (ONS) Congress. Click here to read more of Oncology Nurse Advisor‘s conference coverage.

A 5-tiered approach to the management of central nervous system (CNS) lymphoma allowed for better alleviation of patient symptoms and treatment of side effects. These findings were presented in a poster during the 46th Annual Oncology Nursing Society (ONS) Congress.

Lymphomas of the CNS are rare subtypes of non-Hodgkin lymphoma and carry a poor prognosis for patients, who often present with complex symptoms such as cognitive and sensory deficits, memory impairment, and weakness of the extremities. To address these symptoms, the investigators at the National Institutes of Health (NIH) Clinical Center designed TEDDI-R, a complex protocol for managing patients with primary or secondary CNS lymphoma that includes intravenous, intraventricular, and oral therapies.

The TEDDI-R protocol comprises 5 elements that address the unique cluster of symptoms of patients with CNS lymphoma:

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  • Conduct neurologic examination every 4 hours
  • Establish and maintain an Ommaya reservoir
  • Monitor fluid balance and patient weight daily to assess for endocrine dysfunction
  • Implement fall prevention strategies
  • Provide adequate education for patients and families

Nurses in the lymphoma unit conduct hourly rounds with frequent patient interactions to assess for deteriorating status to ensure interventions are implemented early. They are at the center of a dynamic multidisciplinary team that includes dietitians, swallow therapists, and rehabilitation specialists to address the unique concerns of this predominantly geriatric patient population.

The study authors concluded the TEDDI-R protocol allowed for adequate monitoring of CNS lymphoma symptoms and effective alleviation of side effects.

Read more of Oncology Nurse Advisor‘s coverage of the 46th Annual ONS Congress by visiting the conference page.


Glenn DG, Dayo A, Adams A. When lymphoma crosses the line: nursing care of patients with central nervous system lymphoma. Oncol Nurs Forum. 2021;48(2):abstr 9388.