Central nervous system recurrence of systemic lymphoma in the era of stem cell transplantation - an International Primary Central Nervous System Lymphoma Study Group project

Bromberg, Jacoline E C; Doorduijn, Jeanette K.; Illerhaus, Gerald; Jahnke, Kristoph; Korfel, Agnieszka; Fischer, Lars; Fritsch, Kristina; Kuittinen, Outi; Issa, Samar; Montfort, Cees van; Bent, Martin J. van den

doi:10.3324/haematol.2012.070839

Cited by 57 publications

(36 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This study provided sNHL data mainly at relapse. 5,6,[11][12][13][14] Systemic lymphoma with CNS localization haematologica | 2015; 100 (9) 1203 …”

Section: Discussionmentioning

confidence: 99%

“…Recent retrospectives studies have highlighted the devastating prognosis of CNS involvement at relapse of sNHL with a median overall survival (OS) of seven months to 1.6 years from the time of CNS relapse. 5,6 Little is known on the prognosis of concurrent involvement of CNS or PN at initial diagnosis of sNHL; such patients are excluded from therapeutic trials. The purpose of our study is to determine the outcome of patients with systemic non-Hodgkin lymphoma presenting with neurologic localization at diagnosis, as well as the impact of consolidation in terms of high-dose therapy followed by autologous stem cell transplantation.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Concomitant systemic and central nervous system non-Hodgkin lymphoma: the role of consolidation in terms of high dose therapy and autologous stem cell transplantation. A 60-case retrospective study from LYSA and the LOC network

et al. 2015

View full text Add to dashboard Cite

© F e r r a t a S t o r t i F o u n d a t i o nto report on the therapeutic characteristics of these patients as well as on the role of high-dose therapy and autologous stem cell transplantation in these settings. Methods Study designPatients with histologically confirmed diagnosis of nonHodgkin lymphoma (NHL) made between May 2002 and January 2012 with concomitant systemic and neurological involvement were retrieved from the database of the participating centers, from The Lymphoma Study Association (LYSA) database and the French network for oculocerebral lymphoma (LOC).In accordance with the Declaration of Helsinki, approval of the University Hospital of Amiens Nord-Ouest II Ethics Committee was obtained. Patient eligibilityPatients 18 years or older with an sNHL diagnosis with nervous system involvement were eligible for this study. Diagnosis of NHL was made according to international diagnostic criteria used at the time of diagnosis. Diagnosis of systemic lymphoma was done on lymph nodes or using tissue biopsies. Nervous system involvement was defined by brain parenchyma, intra-ocular, cranial nerve, or meningeal involvement, as well as paravertebral mass and CSF involvement with lymphoma cells. Diagnosis was based on positive cerebrospinal fluid (CSF) cytology or immunophenotyping or by biopsy-proven parenchymal brain localization. Patients with CNS localization based on a typical CT-scan and/or magnetic resonance imaging (MRI) and concurrent sNHL were included as well. Treatment and assessmentsAt base-line assessments of patients and disease included ECOG score, Ann Arbor stage, international prognostic index (IPI), lactate dehydrogenase (LDH) level, bone marrow histology, CSF cytological and/or flow cytometry analysis, CT-scan of the thorax, abdomen and pelvis. Cerebral and vertebral CT-scan and/or MRI were also recorded. G. Damaj et al. 1200haematologica | 2015; 100(9) marrow, bones, spleen, liver, breast, testis, adrenal glands, ovaries, gastro-intestinal tract, lungs and parotid gland; intraventricular, parenchymal, meningeal, cranial © F e r r a t a S t o r t i F o u n d a t i o nThe type of chemotherapy administered, total dose of drugs per cycle and the use of high-dose therapy as well as radiotherapy were retrieved from the original patient files.Response assessment was performed by the on-site referent physician according to the International Working Group Criteria (IWC) for sNHL and the International Primary CNS Lymphoma Collaborative Group for CNS disease. 7,8 Statistical analysisQuantitative variables were expressed as mean±standard deviation or as median [range] and qualitative variables as percentages. The Student or Wilcoxon test was used for comparison of quantitative variables between two groups. χ 2 or Fisher's test were used to compare categorical variables. Overall survival (OS) was defined as the time between diagnosis and the date of death or last follow up. Univariate standard and time-varying (for intensive therapy) Cox models were used to assess prognostic factors for...

show abstract

“…This study provided sNHL data mainly at relapse. 5,6,[11][12][13][14] Systemic lymphoma with CNS localization haematologica | 2015; 100 (9) 1203 …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Concomitant systemic and central nervous system non-Hodgkin lymphoma: the role of consolidation in terms of high dose therapy and autologous stem cell transplantation. A 60-case retrospective study from LYSA and the LOC network

et al. 2015

View full text Add to dashboard Cite

show abstract

“…97,99 It is important to determine whether the relapse is "MTX-sensitive" or not. In MTX-sensitive patients, HD-MTX administration to achieve maximum cytoreduction is advisable, followed by thiotepa or carmustine-based conditioning regimens and ASCT.…”

Section: Cns Relapsementioning

confidence: 99%

“…98 Long-term survival in patients who underwent ASCT has also been reported in a retrospective international multicenter study. 99 Other published conditioning regimens include other combinations including cyclophosphamide, carmustine, etoposide, busulfan and thiotepa, with or without rituximab. 93,100,101 All such studies demonstrate that significant progress has been made toward cure in this difficult condition that was almost systematically fatal a few years ago.…”

mentioning

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

View full text Add to dashboard Cite

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...

show abstract

“…However, a biopsy may be challenging in vulnerable brain regions, and in some cases histological findings are inconclusive, particularly after steroid pre-treatment. The utility of cerebrospinal fluid (CSF) diagnostics based on tumour cell identification such as conventional CSF cytomorphology, flow cytometry [5] or monoclonality assessment by polymerase chain reaction [6] is limited to cases with leptomeningeal involvement which is present in approximately 40-50% of SCNSL and in less than 20% of PCNSL [7,8]. Identification of reliable diagnostic markers in CSF representing an easily accessible compartment is highly desirable to facilitate the diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Osteopontin in cerebrospinal fluid as diagnostic biomarker for central nervous system lymphoma

et al. 2016

View full text Add to dashboard Cite

Central nervous system lymphoma (CNSL) is diagnostically challenging. The identification of reliable and easy to measure biomarkers is desirable to facilitate diagnosis. Here, we evaluated the value of cerebrospinal fluid (CSF) osteopontin (OPN) as a diagnostic biomarker for CNSL. OPN concentrations in CSF from 37 patients with CNSL (29 with primary CNSL and 8 with secondary CNS involvement of systemic lymphoma) and 36 controls [6 patients with inflammatory CNS disease other than multiple sclerosis (MS), 8 with MS, 9 with glioblastoma (GBM) and 13 healthy controls] were determined using an enzyme-linked immunosorbent assay. Non-parametric tests and receiver operating characteristic (ROC) curves were performed for determination of diagnostic accuracy. Median CSF OPN level in all CNSL patients was 620 ng/mL and higher than in patients with inflammatory CNS disease (356 ng/mL); P < .05, MS (163 ng/mL); P < .01, GBM (41 ng/mL); P < .01, or healthy controls (319 ng/mL); P < .01. The area under the ROC curve was 0.865 [95 % confidence interval (CI) 0.745-0.985] for differentiating CNSL and patients with inflammatory CNS disease; 0.956 (95 % CI 0.898-1.000) for CNSL and MS patients; 0.988 (95 % CI 0.964-1.000) for CNSL and GBM patients, and 0.915 (95 % CI 0.834-0.996) for CNSL patients and healthy controls. In multivariate analysis, high CSF OPN level was associated with shorter progression-free (HR 1.61, 95 % CI 1.13-2.31; P = .009) and overall survival (HR 1.52, 95 % CI 1.04-2.21; P = .029). CSF OPN is a potential biomarker in CNSL.

show abstract

Central nervous system recurrence of systemic lymphoma in the era of stem cell transplantation - an International Primary Central Nervous System Lymphoma Study Group project

Cited by 57 publications

References 26 publications

Concomitant systemic and central nervous system non-Hodgkin lymphoma: the role of consolidation in terms of high dose therapy and autologous stem cell transplantation. A 60-case retrospective study from LYSA and the LOC network

Concomitant systemic and central nervous system non-Hodgkin lymphoma: the role of consolidation in terms of high dose therapy and autologous stem cell transplantation. A 60-case retrospective study from LYSA and the LOC network

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

Osteopontin in cerebrospinal fluid as diagnostic biomarker for central nervous system lymphoma

Contact Info

Product

Resources

About