Central Nervous System Relapse in Non-Hodgkin Lymphoma

Bollen, Edward L.E.M.; Brouwer, Rolf E.; Hamers, S; Hermans, J.; Kluin, Marieke; Sankatsing, Sanjay U. C.; A-Tjak, R V; Charvát, Martin; Kluin-Nelemans, Hanneke C.

doi:10.1001/archneur.1997.00550190044013

Cited by 78 publications

(66 citation statements)

References 15 publications

(6 reference statements)

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“…[3][4][5][6]18,19 If patients with DLBCL and treated with CHOP or CHOP-like regimens with or without CNS prophylaxis were considered, CNS events were in the range of 4% to 7%. 1,2,9, 10 The French Groupe d'Etude des Lymphomes de l'Adulte (GELA) demonstrated a reduction of CNS events to 2.2% in patients treated with ACVBP (doxorubicin, cyclophosphamide, vindesine, bleomycin, and prednisone) and both i.th.…”

Section: Discussionmentioning

confidence: 99%

“…Because the incidence of CNS disease in diffuse large B-cell lymphoma (DLBCL) is low, [1][2][3][4][5][6] prophylactic measures have been restricted to patients with disease characteristics empirically found to convey an increased risk of CNS disease. More recently, risk models have been developed derived from analyses of prospective studies.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

CNS events in elderly patients with aggressive lymphoma treated with modern chemotherapy (CHOP-14) with or without rituximab: an analysis of patients treated in the RICOVER-60 trial of the German High-Grade Non-Hodgkin Lymphoma Study Group (DSHNHL)

Boehme

Schmitz

Zeynalova

et al. 2009

Blood

285

260

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

CNS events in elderly patients with aggressive lymphoma treated with modern chemotherapy (CHOP-14) with or without rituximab: an analysis of patients treated in the RICOVER-60 trial of the German High-Grade Non-Hodgkin Lymphoma Study Group (DSHNHL)

Boehme

Schmitz

Zeynalova

et al. 2009

Blood

285

260

View full text Add to dashboard Cite

“…Other clinically aggressive lymphomas such as lymphoblastic and Burkitt-type lymphomas reportedly involve the CNS in 7-13% of cases at diagnosis and in 16.5-39% during the course of disease (23,24). However, because current clinical staging protocols and evaluations of MCL patients do not routinely include CSF examination as do the protocols for other aggressive lymphomas, the data needed to accurately characterize the true incidence of CSF involvement in MCL are not currently available.…”

Section: Discussionmentioning

confidence: 99%

Cerebrospinal Fluid Involvement in Mantle Cell Lymphoma

et al. 2002

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Mantle cell lymphoma (MCL) is an aggressive neoplasm that is incurable by standard therapy. Patients often present with high-stage disease (Stages III-IV) and frequently have involvement at multiple extranodal sites. Although the gastrointestinal tract, spleen, lung, pleura, bone marrow, and peripheral blood are among the most commonly involved tissues, MCL may also disseminate to so-called sanctuary sites including the central nervous system. Despite this, current clinical evaluations do not routinely include assessment of the cerebrospinal fluid (CSF) for lymphomatous infiltrates at presentation, and moreover, only few authors have specifically examined CSF involvement in MCL. In this study, we reviewed the medical records of 108 patients with MCL seen at three centers over a 5-year period to determine the rate of CSF sampling and the frequency of CSF involvement by MCL. The clinical and cytologic characteristics associated with CSF involvement were also studied. Central nervous system (CNS) signs and/or symptoms prompted CSF sampling in 25/108 patients (23%). Specific radiographic abnormalities were present in 9/25 patients (36%). CSF involvement by MCL was identified in 10 of the 25 CSF-sampled patients (40%) by morphology (3 patients), flow cytometry alone (1 patients), or both (6 patients). The CSF-positive cases included two blastoid variants. The CSF cytology of the nine morphologically positive cases was pleomorphic, and prominent cytoplasmic granules were observed in two cases. The overall rate of CSF involvement by MCL among the cohort was 9%, which is comparable to that reported in other selected studies examining this issue.

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“…3,4,7,14,17,20,22,24,26) Furthermore, testicular involvement and bone marrow involvement are statistically significant risk factors for CNS involvement. 1,12) On the other hand, extracranial invasion of CNS lymphoma occurs in various organs of the body, 16) but testicular infiltration was confirmed in four of 14 2) and three of six 24) cases, so CNS NHL also tends to invade the testis. Even considering the prostate lesion, we cannot conclude which was the primary lesion.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, CNS involvement has been found at the initial medical examination in 1.2% to 2.1% of patients with systemic NHL. 1,11) We report a case of diffuse mixed B cell lymphoma associated with multicentric involvement of the CNS and testis.…”

Section: Introductionmentioning

confidence: 99%

Multicentric Involvement of Non-Hodgkin's Lymphoma in the Central Nervous System and Testis-Case Report-

Ono

Arimoto

Wada

et al. 2004

Neurol. Med. Chir.(Tokyo)

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A 73-year-old male presented with diffuse mixed B cell lymphoma with involvement of the central nervous system (CNS) and testis manifesting as mild disorientation and aphasia. A left frontal cerebral mass and a right testicular tumor were found, and both lesions were surgically resected. Histological examination revealed diffuse mixed B cell type malignant lymphoma in the CNS and testis. The patient received irradiation to the head, and his initial symptoms improved. Pelvic computed tomography revealed enlargement of the contralateral testis and prostate. Needle biopsy confirmed lymphoma. The patient died 5 months after the initial diagnosis of septic shock. Autopsy examination revealed lymphoma cell invasion of the lung, bone marrow, prostate gland, and thalamus, but without involvement of the systemic lymph nodes. In a patient with an intracranial lymphoma, it is important to determine if the lesion is primary or metastatic and to plan medical treatment including systemic chemotherapy as soon as possible. Improvement of the prognosis of systemic non-Hodgkin's lymphoma with CNS involvement requires the detection and effective treatment of systemic lesions as well as the control of the CNS lesions.

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Central Nervous System Relapse in Non-Hodgkin Lymphoma

Abstract: Patients with high- and intermediate-grade NHL carry a considerable risk of CNS relapse. Advanced stage is an additional independent risk factor. The role of CNS prophylaxis seems to be disappointing, but a retrospective analysis cannot be conclusive. Prognosis after CNS relapse is poor.

Cited by 78 publications

References 15 publications

CNS events in elderly patients with aggressive lymphoma treated with modern chemotherapy (CHOP-14) with or without rituximab: an analysis of patients treated in the RICOVER-60 trial of the German High-Grade Non-Hodgkin Lymphoma Study Group (DSHNHL)

CNS events in elderly patients with aggressive lymphoma treated with modern chemotherapy (CHOP-14) with or without rituximab: an analysis of patients treated in the RICOVER-60 trial of the German High-Grade Non-Hodgkin Lymphoma Study Group (DSHNHL)

Cerebrospinal Fluid Involvement in Mantle Cell Lymphoma

Multicentric Involvement of Non-Hodgkin's Lymphoma in the Central Nervous System and Testis-Case Report-

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