CSF evaluation in primary CNS lymphoma patients by PCR of the CDR III IgH genes

Gleißner, Beate; Siehl, J.; Korfel, Agnieszka; Reinhardt, Richard; Thiel, Eckhard

doi:10.1212/wnl.58.3.390

Cited by 89 publications

(53 citation statements)

References 20 publications

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“…14,54 However, these parameters are nonspecific and therefore unreliable for routine diagnosis of CNS disease. 55,56 Similarly, CSF levels of soluble (s)CD21, sCD22, sCD24, sCD38, sCD44, sCD72, and immunoglobulin (IG) heavy and light chain isotypes are of limited diagnostic utility. 57 Similar rates of CSF-positive cases (8%-13% vs. 11%-16%) have been obtained by polymerase chain reaction (PCR) analysis of IG gene sequences and cytomorphology, respectively, with a high frequency of unexplained discrepant cases, 58 suggesting that the utility of PCR analysis of IG genes may be limited to selected cases in which CSF cytology and FCM are not informative.…”

Section: Fj Peñalver Et Almentioning

confidence: 99%

Guidelines for diagnosis, prevention and management of central nervous system involvement in diffuse large B-cell lymphoma patients by the Spanish Lymphoma Group (GELTAMO)

et al. 2016

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Several factors hinder the identification of risk factors for central nervous system (CNS) involvement in diffuse large B-cell lymphoma (DLBCL), including the retrospective nature of most studies, the relatively low frequency of CNS relapse in DLBCL, and the heterogeneity of CNS prophylaxis methods used in these studies. Moreover, the impact of newly developed diagnostic tools (such as multiparameter flow cytometry [FCM]) and new treatments introduced in the last decade, in particular rituximab, has still not been fully clarified.Several studies 4,5,[7][8][9][10] and a recent meta-analysis 1 have described a decrease in rates D iffuse large B-cell lymphoma patients have a 5% overall risk of central nervous system events (relapse or progression), which account for high morbidity and frequently fatal outcomes, 1 and shortened overall survival of <6 months.2 Early diagnosis of central nervous system events is critical for successful treatment and improved prognosis. Identification of patients at risk of central nervous system disease is critical to accurately identify candidates for central nervous system prophylaxis vs. therapy. [3][4][5] This report by the Spanish Lymphoma Group (GELTAMO) aims to provide useful guidelines and recommendations for the prevention, diagnosis, and treatment of central nervous system diffuse large B-cell lymphoma patients with, or at risk of, leptomeningeal and/or brain parenchyma lymphoma relapse. A panel of lymphoma experts working on behalf of GELTAMO reviewed all data published on these topics available in PubMed up to May 2016. Recommendations were classified according to the Grading of Recommendations Assessment Development and Evaluation (GRADE) approach. 6 A practical algorithm based on the proposed recommendations was then developed (Figure 1 have concluded that the incidence of CNS relapse decreased after the introduction of rituximab (Table 1). The identification of risk factors has been the major goal of many studies of CNS involvement. Several large retrospective studies conducted in the pre-rituximab era [12][13][14][15] reported higher rates of CNS relapse in patients with increased serum lactate dehydrogenase (LDH) levels and/or involvement of >1 extranodal site, although these factors failed to predict CNS relapse in more than half of all cases.12 In addition to the involvement of >1 extranodal site and increased LDH, International Prognostic Index (IPI) score was also identified as an independent predictor for CNS relapse in other studies.13,16 A post-rituximab era study of 399 DLBCL patients, randomized to R-CHOP or CHOP chemotherapy, 3 identified an age-adjusted IPI (aaIPI) >1 as the only risk factor for CNS involvement, although a high aaIPI score was recorded for more than 60% of the patients. When aaIPI was excluded from the analysis, elevated LDH and a poor performance status (PS >1) were identified as independent predictive factors for CNS relapse. Similarly, in the randomized RICOVER-60 trial, 4 the combination of increased LDH levels, the involvement of >1 ex...

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Section: Fj Peñalver Et Almentioning

confidence: 99%

Guidelines for diagnosis, prevention and management of central nervous system involvement in diffuse large B-cell lymphoma patients by the Spanish Lymphoma Group (GELTAMO)

et al. 2016

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“…Importantly, flow cytometry can be combined with molecular techniques including PCR to improve sensitivity in detecting CSF involvement of lymphoma (113,114). Furthermore, broad-spectrum tumor cell-specific antigens could be fluorescently labeled and used in flow cytometric detection of CNS malignancy (13).…”

Section: Perspectivesmentioning

confidence: 99%

Flow cytometric characterization of cerebrospinal fluid cells

Graaf

Jongste

Kraan

et al. 2011

Cytometry Part B Clinical

114

115

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Flow cytometry facilitates the detection of a large spectrum of cellular characteristics on a per cell basis, determination of absolute cell numbers and detection of rare events with high sensitivity and specificity. White blood cell (WBC) counts in cerebrospinal fluid (CSF) are important for the diagnosis of many neurological disorders. WBC counting and differential can be performed by microscopy, hematology analyzers, or flow cytometry. Flow cytometry of CSF is increasingly being considered as the method of choice in patients suspected of leptomeningeal localization of hematological malignancies. Additionally, in several neuroinflammatory diseases such as multiple sclerosis and paraneoplastic neurological syndromes, flow cytometry is commonly performed to obtain insight into the immunopathogenesis of these diseases. Technically, the low cellularity of CSF samples, combined with the rapidly declining WBC viability, makes CSF flow cytometry challenging. Comparison of flow cytometry with microscopic and molecular techniques shows that each technique has its own advantages and is ideally combined. We expect that increasing the number of flow cytometric parameters that can be simultaneously studied within one sample, will further refine the information on CSF cell subsets in low-cellular CSF samples and enable to define cell populations more accurately. V C 2011 International Clinical Cytometry Society

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“…Inicialmente, se había sugerido que, entre estas técnicas, los estudios genéticos y moleculares podrían ser de mayor utilidad que la citometría de flujo, dada el escaso número de células y la viabilidad de este tipo de muestras (8,9). No obstante, trabajos más recientes sugieren que los análisis inmunofenotípicos por citometría de flujo que emplean estrategias multiparamétricas, constituyen una alternativa atractiva a las técnicas antes referidas.…”

Section: Caracterización De Poblaciones Celulares En La Urticaria Papunclassified

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2012

biomedica

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CSF evaluation in primary CNS lymphoma patients by PCR of the CDR III IgH genes

Cited by 89 publications

References 20 publications

Guidelines for diagnosis, prevention and management of central nervous system involvement in diffuse large B-cell lymphoma patients by the Spanish Lymphoma Group (GELTAMO)

Guidelines for diagnosis, prevention and management of central nervous system involvement in diffuse large B-cell lymphoma patients by the Spanish Lymphoma Group (GELTAMO)

Flow cytometric characterization of cerebrospinal fluid cells

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