Hot niches, cold niches, and the clone within

outcomes: synchronous CNS-systemic relapse defines the highest-risk group and warrants intensified strategies and innovative trial designs.Wherever feasible, thiotepa-ASCT remains the consolidation modality most consistently associated with durable survival in de novo and CNS-isolated relapse.Transplant eligibility should be reassessed dynamically; patients initially deemed ineligible may become candidates after prephase therapy or induction.CNSisolated relapse behaves more like primary CNS lymphoma than systemic disease, and the low systemic failure rate supports methotrexate-based multiagent induction followed by thiotepa-ASCT. 2 CAR-T remains essential for transplantineligible or refractory disease, although its effectiveness is influenced by disease control at infusion and the use of CNSpenetrant bridging.