High incidence of occult leptomeningeal disease detected by flow cytometry in newly diagnosed aggressive B-cell lymphomas at risk for central nervous system involvement: the role of flow cytometry versus cytology

Hegde, Upendra P.; Filie, Armando C.; Little, Richard F.; Janik, John E.; Grant, Nicole; Steinberg, Seth M.; Dunleavy, Kieron; Jaffe, Elaine S.; Abati, Andrea; Stetler‐Stevenson, Maryalice; Wilson, Wyndham H.

doi:10.1182/blood-2004-05-1982

Cited by 318 publications

(288 citation statements)

References 26 publications

Supporting

Mentioning

266

Contrasting

Unclassified

Order By: Relevance

“…12 However, the use of multiparameter flow cytometry in addition to conventional cytology will improve the identification of leptomeningeal disease in patients with IVL, as reported recently in patients with aggressive nonHodgkin lymphoma. 31,32 The most striking feature of recurrent NL is its timing. It is noteworthy that all 4 of our patients developed NL during or shortly they completed chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

High frequency of neurolymphomatosis as a relapse disease of intravascular large B‐cell lymphoma

Matsue

Hayama

Iwama

et al. 2011

Cancer

View full text Add to dashboard Cite

BACKGROUND: Intravascular large B-cell lymphoma (IVL) is characterized by lymphoma cell proliferation in the lumina of small vessels in various organs. A high incidence of neurologic symptoms associated with the central nervous system has been reported, but peripheral nerve involvement (neurolymphomatosis [NL]) rarely has been described. METHODS: The medical records from patients who were diagnosed with IVL over the past 4 years were reviewed. A diagnosis of NL was made based on the combination of neurologic symptoms and their correspondence with imaging studies, such as magnetic resonance imaging (MRI), 18 F-fluoro-2-deoxy-D-glucose (FDG)-positron emission tomography/computed tomography (PET/CT), and/or the histologic confirmation of lymphoma cells within the peripheral nerves, nerve root/plexuses, or cranial nerves. RESULTS: Four patients with NL were identified among 11 patients who had IVL. All cases of NL occurred as relapsed disease during or shortly after the completion of chemotherapy. Although MRI studies of the brains and whole spines revealed nerve infiltration by gadolinium enhancement in 2 patients, the technology was not sensitive enough to detect such infiltration in the remaining 2 patients. In contrast, FDG-PET/CT studies successfully revealed cranial or peripheral nerve lesions in all 4 patients and was useful for evaluating therapeutic response. Patients received treatment with high-dose methotrexate with or without other systemic chemotherapy, which achieved varied success. Further studies will be needed to determine the optimal treatment. CONCLUSIONS: Considering the rarity of IVL and NL, the current observations suggested that IVL may have a predilection not only for the vessels but also for both the central and peripheral nervous systems. Cancer 2011;117:4512-

show abstract

Section: Discussionmentioning

confidence: 99%

High frequency of neurolymphomatosis as a relapse disease of intravascular large B‐cell lymphoma

Matsue

Hayama

Iwama

et al. 2011

Cancer

View full text Add to dashboard Cite

show abstract

“…Given the low sensitivity of cerebrospinal fluid cytology studies, a negative test is probably insufficient to rule out subclinical CNS involvement in such high-risk patients; in these cases, other techniques such as flow cytometry should be employed to increase detection rates. [29][30][31] The detection of subclinical CNS involvement may help to guide treatment recommendations and define the prognosis of such patients better.…”

Section: Clinical Factor Chop (N=12) R-chop (N=8)mentioning

confidence: 99%

Diffuse large B-cell lymphoma with involvement of the kidney: outcome and risk of central nervous system relapse

Villa¹,

Connors²,

Sehn³

et al. 2011

Haematologica

View full text Add to dashboard Cite

BackgroundRenal involvement is uncommon in diffuse large B-cell lymphoma. Recent data suggest that it is an independent risk factor for central nervous system relapse. We reviewed the clinical features, risk of central nervous system involvement, and survival of patients with diffuse large Bcell lymphoma with involvement of the kidney at diagnosis. Design and MethodsAll patients with diffuse large B-cell lymphoma and renal involvement diagnosed from January 1, 1982 to December 31, 2008 at the British Columbia Cancer Agency were retrospectively identified in the Lymphoid Cancer Database. Patients were included if they were 16 years old or over, had advanced stage disease [stage III /IV, or stage I/II with B symptoms or bulky mass (>10 cm)] and were treated with curative intent. Central nervous system involvement was diagnosed by cerebrospinal fluid cytology, radiology or clinically. ResultsWe identified 55/2656 (2%) patients with diffuse large B-cell lymphoma and renal involvement at diagnosis. The male to female ratio was 2:1. The patients' median age was 58 years. Bilateral renal involvement was present in 24 (44%) and stage IV disease in 50 (91%). The International Prognostic Index score was 3, 4 or 5 in 52 (95%), the glomerular filtration rate was less than 30 mL/min/m 2 in 9 (16%) and elevated lactate dehydrogenase was recorded in 46 (84%). Twentyfive (46%) patients received CHOP plus rituximab and 30 (54%) received CHOP-like regimens without rituximab. In total, 20 (36%) patients had central nervous system involvement: four at the time of diagnosis and 16 at relapse. The median time to central nervous system relapse was 5.6 months (range, 1.2 months-4.6 years), and was not affected by the addition of rituximab (P=0.547). The 5-year overall and progression-free survival rates for the whole cohort were 29% and 25%, respectively. In patients who received rituximab, there were trends towards improved 5-year overall survival (43% versus 18%, P=0.071) and progression-free survival (40% versus 13%, P=0.057). ConclusionsThere is an exceptionally high incidence of central nervous system relapse in patients with diffuse large B-cell lymphoma and kidney involvement at diagnosis. The addition of rituximab may improve overall survival in this poor-risk population, likely through improved control of systemic disease.

show abstract

“…2,3 This has led to the development of clinical risk paradigms to identify patients for CNS prophylaxis, but only a few patients will potentially benefit. 1,4 Among patients who develop CNS disease, only a small fraction have cytologically detectable malignant cells in the CSF on initial staging. 4 This observation raised the question of whether cytology was unable to detect low volume disease or if leptomeningeal spread was a late event.…”

Section: Introductionmentioning

confidence: 99%

Detection and outcome of occult leptomeningeal disease in diffuse large B-cell lymphoma and Burkitt lymphoma

et al. 2014

View full text Add to dashboard Cite

show abstract

High incidence of occult leptomeningeal disease detected by flow cytometry in newly diagnosed aggressive B-cell lymphomas at risk for central nervous system involvement: the role of flow cytometry versus cytology

Cited by 318 publications

References 26 publications

High frequency of neurolymphomatosis as a relapse disease of intravascular large B‐cell lymphoma

High frequency of neurolymphomatosis as a relapse disease of intravascular large B‐cell lymphoma

Diffuse large B-cell lymphoma with involvement of the kidney: outcome and risk of central nervous system relapse

Detection and outcome of occult leptomeningeal disease in diffuse large B-cell lymphoma and Burkitt lymphoma

Contact Info

Product

Resources

About