Central Nervous System Relapse in a Patient with Mantle Cell Lymphoma in Continuous Clinical and Molecular Remission at Six Years Since Autografting

Ladetto, Marco; Sametti, Selina; Astolfi, Monica; Corradini, Paolo; Ricca, Irene; Drandi, Daniela; Pileri, Alessandro; Tarella, Corrado

doi:10.3109/10428190109097668

Cited by 6 publications

(2 citation statements)

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“…It is unclear whether specific CNS prophylaxis given to patients at high risk offers any benefit, particularly with regard to the prevention of isolated CNS relapse as a first event in a patient otherwise in systemic complete response. This may however occur even in patients with documented molecular systemic remission (Ladetto et al , 2001). The available data would support the assertion that initial treatment with immuno‐chemotherapy followed by high‐dose treatment that includes CNS‐penetrating agents (with or without intrathecal therapy) may be sufficient in terms of CNS prophylaxis, at least in the younger patient (Romaguera et al , 2005; Ritchie et al , 2007; Geisler et al , 2008).…”

Section: Discussionmentioning

confidence: 99%

Mantle cell lymphoma with central nervous system involvement: frequency and clinical features

et al. 2009

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SummaryReported rates of central nervous system (CNS) involvement in mantle cell lymphoma (MCL) are highly variable but substantial (4-26%). Data is lacking regarding risk factors for CNS relapse, and for those patients in whom CNS prophylaxis could be beneficial. We present single institution retrospective analysis of data of baseline features, clinical course, rate of CNS disease and putative risk factors in 62 patients with MCL (18 female, 44 male). CNS disease (all cases were symptomatic) occurred in four patients at a median of 12 months (range 1-58) from diagnosis, with a crude incidence of 6AE5% and 5-year actuarial incidence of 5 ± 3%. Two cases had blastic MCL at diagnosis. Survival after CNS relapse ranged from 2-9 months. Patients who developed CNS disease had a significantly shorter survival from diagnosis than those who did not (P = 0AE0024). Symptomatic CNS disease in patients with MCL either at presentation or relapse is an uncommon but devastating complication. In younger patients, more aggressive immunochemotherapy regimens containing CNS-penetrating agents may reduce the incidence of CNS disease. While not routinely justified for all patients, CNS prophylaxis may particularly benefit patients with blastic histology at diagnosis, or those with systemic relapse after first-line treatment.

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Section: Discussionmentioning

confidence: 99%

Mantle cell lymphoma with central nervous system involvement: frequency and clinical features

et al. 2009

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“…Because CSF analysis is not usually used in MCL staging, the frequency of asymptomatic involvement is unknown. However, late CNS relapses seen after stem cell transplantation had been described, suggesting that the CNS serves as a sanctuary for MCL in asymptomatic patients (14). We hypothesize that neoplastic B cells, which can express the same adhesion receptors involved in cell trafficking and homing as normal circulating lymphocytes (15, 16), can be recruited to sites of inflammation including the CSF.…”

Section: Discussionmentioning

confidence: 99%

Clinical significance of monoclonal B cells in cerebrospinal fluid

Nowakowski¹,

Call²,

Kurtin³

et al. 2004

Cytometry Part B Clinical

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Late‐delayed cerebral involvement in systemic non‐Hodgkin lymphoma

Lossos

Ashhab

Sverdlin

et al. 2004

Cancer

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BACKGROUNDCentral nervous system involvement is a well recognized complication of systemic non‐Hodgkin lymphoma. Most central nervous system recurrences occur within the first 2 years after the initial diagnosis and are considered to represent clonally related recurrence of systemic disease. The authors attempted to investigate the clonal relation between the late‐delayed central nervous system involvement and the original systemic tumor.METHODSThe authors studied archival, formalin fixed, paraffin embedded tissue samples from 8 patients with isolated cerebral involvement diagnosed > 3 years after their initial presentation with aggressive, systemic, B‐cell non‐Hodgkin lymphoma. The rearranged immunoglobulin heavy‐chain variable region genes (VH) from both sites were amplified by polymerase chain reaction and were sequenced when necessary.RESULTSIn three of five patients who had interpretable results, a distinct, monoclonal, VH family‐specific band profile was obtained from the cerebral and systemic lymphoma. In the other two patients, a similar VH band pattern was observed and also was compared using direct sequencing, which demonstrated sequence differences between tumors from the two sites.CONCLUSIONSClonal variance between the cerebral and systemic lymphoma in these patients suggested the possibility that some instances of late‐delayed recurrence in the central nervous system represent a second, new B‐cell lymphoma rather than a true recurrence of the original systemic tumor, a finding that may have significant clinical and biologic implications. Cancer 2004. © 2004 American Cancer Society.

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Central Nervous System Relapse in a Patient with Mantle Cell Lymphoma in Continuous Clinical and Molecular Remission at Six Years Since Autografting

Cited by 6 publications

References 9 publications

Mantle cell lymphoma with central nervous system involvement: frequency and clinical features

Mantle cell lymphoma with central nervous system involvement: frequency and clinical features

Clinical significance of monoclonal B cells in cerebrospinal fluid

Late‐delayed cerebral involvement in systemic non‐Hodgkin lymphoma

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