Central nervous system prophylaxis in peripheral T-cell lymphoma

Pro, Barbara; Perini, Guilherme Fleury

doi:10.1182/blood-2010-02-266890

Cited by 22 publications

(16 citation statements)

References 4 publications

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“…[20] In the limited literature from North America the reported risk of CNS involvement in those with T-cell lymphoma appears much lower ranging from 2.4–3.6%. [16,18]. In our series 6.5% (15/231) patients had CNS involvement at any point in their disease course.…”

Section: Discussionmentioning

confidence: 46%

“…Prior retrospective series suggest that the rate of CNS involvement in PTCL ranges from 2–9% [15–18]. One series from Korea found that presence of an elevated LDH and sinus involvement as risk factors for CNS involvement in PTCL.…”

Section: Discussionmentioning

confidence: 99%

“…In a letter to the editor Pro et al reported a much lower risk of CNS relapse with a rate of 2.4% in patients with PTCL at MD Anderson Cancer Center. Of the patients who had CNS relapses, all had extranodal involvement and four had an elevated LDH [18]. …”

Section: Introductionmentioning

confidence: 99%

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Central nervous system involvement in T-cell lymphoma: A single center experience

et al. 2016

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Background We characterized the incidence of central nervous system (CNS) involvement, risk factors and outcome in a large single institution dataset of peripheral T cell lymphoma (PTCL). Methods Retrospective review of the PTCL database at Memorial Sloan Kettering Cancer Center. We identified 231 patients with any subtype of PTCL between 1994–2011 with a minimum 6 months of follow-up or an event defined as relapse or death. Results Histologies included peripheral T cell lymphoma – no not otherwise specified (PTCL-NOS) (31.6%), angioimmunoblastic (16.9%), anaplastic large cell lymphoma (ALCL), ALK- (12.1%), ALCL, ALK+ (6.1%), extranodal NK/T-cell lymphoma (7.4%), adult T-cell leukemia/lymphoma (ATLL) (7.4%), and transformed mycosis fungoides (8.7%). 17 patients had CNS disease (7%). Fifteen had CNS involvement with PTCL and two had diffuse large B cell lymphoma and glioblastoma. Median time to CNS involvement was 3.44 months (0.16 to 103.1). CNS prophylaxis was given to 24 patients (primarily intrathecal methotrexate). Rates of CNS involvement were not different in patients who received prophylaxis. Univariate analysis identified stage III-IV, bone marrow involvement, >1 extranodal site and ATLL as risk factors for CNS disease. On multivariate analysis, >1 extranodal site and international prognostic index (IPI) ≥ 3 were predictive for CNS involvement. The median survival of patients with CNS involvement was 2.63 months (0.10 to 75). Conclusions Despite high relapse rates, PTCL, except ATLL, carries a low risk of CNS involvement. Prognosis with CNS involvement is poor and risk factors include: >1 extra nodal site and IPI ≥ 3.

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Section: Discussionmentioning

confidence: 46%

Section: Discussionmentioning

confidence: 99%

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Central nervous system involvement in T-cell lymphoma: A single center experience

et al. 2016

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“…A single-center review reported CNS relapse in 6 (2.4%) of 250 patients, and in a population-based study on relapsed PTCL, 12 (7.8%) of 153 relapses included the CNS. 14,15 The most extensive study in PTCL included 228 patients, with extranodal NK/T-cell lymphoma excluded, and found an incidence of 8.8% CNS relapses. 16 In that study, the identified risk factors for CNS relapse were elevated lactate dehydrogenase and paranasal sinus involvement.…”

Section: Introductionmentioning

confidence: 99%

Central nervous system relapse in peripheral T-cell lymphomas: a Swedish Lymphoma Registry study

Ellin

Landström

Jerkeman

et al. 2015

Blood

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Key Points• CNS involvement at relapse/ progression in PTCL occurred at a frequency similar to what is seen in aggressive B-cell lymphomas.• Outcome after relapse is generally very poor in patients with PTCL and is not significantly altered by presence of CNS involvement at relapse.Central nervous system (CNS) relapse in non-Hodgkin lymphoma (NHL) carries a very poor prognosis. Risk factors and outcome have been studied in aggressive B-cell lymphomas, but very little is known about the risk in peripheral T-cell lymphoma (PTCL). We aimed at analyzing risk factors for CNS involvement at first relapse or progression, as well as the outcome of these patients, in a large population-based cohort of patients with PTCL. Twenty-eight out of 625 patients (4.5%) developed CNS disease over time. In multivariable analysis, disease characteristics at diagnosis independently associated with an increased risk for later CNS involvement were involvement of more than 1 extranodal site (hazard ratio [HR], 2.60; 95% confidence interval [CI], 1.07-6.29; P 5 .035) and skin (HR, 3.51; 95% CI, 1.26-9.74; P 5 .016) and gastrointestinal involvement (HR, 3.06; 95% CI, 1.30-7.18; P 5 .010). The outcome of relapsed/refractory patients was very poor, and CNS involvement was not associated with a significantly worse outcome compared with relapsed/refractory patients without CNS involvement in multivariable analysis (HR, 1.6; 95% CI, 0.96-2.6; P 5 .074). The results from the present study indicate that CNS relapse in PTCL occurs at a frequency similar to what is seen in aggressive B-cell lymphomas, but the poor outcomes in relapse are largely driven by systemic rather than CNS disease. (Blood. 2015;126(1):36-41)

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“…Prior retrospective series suggest that the rate of CNS involvement in PTCL ranges from 2-9% [15][16][17][18]. One series from Korea found that presence of an elevated LDH and sinus involvement as risk factors for CNS involvement in PTCL.…”

Section: Discussionmentioning

confidence: 99%

Central Nervous System Involvement in T-cell Lymphoma: A Single Center Experience

Mehta

Gurion

Maragulia

et al. 2015

Clinical Lymphoma Myeloma and Leukemia

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Central nervous system prophylaxis in peripheral T-cell lymphoma

Cited by 22 publications

References 4 publications

Central nervous system involvement in T-cell lymphoma: A single center experience

Central nervous system involvement in T-cell lymphoma: A single center experience

Central nervous system relapse in peripheral T-cell lymphomas: a Swedish Lymphoma Registry study

Central Nervous System Involvement in T-cell Lymphoma: A Single Center Experience

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