CNS prophylaxis in lymphoma: Who to target and what therapy to use

Hill, Quentin A.; Owen, Roger G.

doi:10.1016/j.blre.2006.02.001

Cited by 128 publications

(106 citation statements)

References 142 publications

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“…This result is concordant with those that have been reported in the literature and showing a median CNS relapse rate of 11% (Table III) (range: 0-29%). The risk of CNS relapses in patients with PBL appears greater than that has been reported for aggressive nodal NHL and approximately estimated to 5% [38]. The situation of PBL could be compared with that of primary testicular lymphoma for which CNS relapses occurred in 15% of cases [39].…”

Section: Discussionmentioning

confidence: 98%

Primary breast non‐Hodgkin's lymphoma: A large single center study of initial characteristics, natural history, and prognostic factors

et al. 2009

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The aims of this study were to define the initial pathological and clinical characteristics, and prognostic factors of patients with primary breast malignant lymphoma (PBL). All patients treated at the Institut Curie for lymphoma with breast involvement were reviewed. A pathological review of all cases was performed. Fortyfive cases were selected in whom 38 cases were of diffuse large B-cell lymphoma. A complete analysis was then performed on these 38 patients. Twenty out of 28 cases (71%) of cases were Bcl-2 positive and four out of 28 (14%) had a CD10 positive staining. Peculiar initial characteristics showed nodal involvement in 58% of the cases and two or more extra-nodal sites in 31% of the cases. Among the 37 patients for whom all data were available, and according to the International Prognostic Index, 19 patients (51%) were classified in the low-risk group, 5 cases (14%) in the low-to intermediate-risk group, 6 patients (16%) in the intermediate-to high-risk group, and 7 (19%) case in the high-risk group. At the end of initial therapy, 34 patients (89%) achieved CR. With a median follow-up of 96 months, 18 patients (47%) relapsed of whom 3 had a relapse in central nervous system site. The 5-year disease-free (DFS) and overall survivals (OS) were 54% and 61%, respectively. In multivariate analysis, the presence of 2 or more extranodal sites was prognostic for lower DFS (P 5 0.0008) and OS (P 5 0.09), and a performance status ‡1 was prognostic for lower OS (P 5 0.005). Finally, when our series was compared with a historical series of 111 patients with aggressive nodal lymphomas, we observed significant lower survival rates in localized PBL (P < 0.03). Initial breast localization has a pejorative impact on the outcome of patients with Non-Hodgkin's Lymphoma (NHL), with an impressive adverse influence of additional extranodal sites. These results suggest a specific management of NHL with breast involvement. Am. J. Hematol. 84:133-139, 2009. V

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Section: Discussionmentioning

confidence: 98%

Primary breast non‐Hodgkin's lymphoma: A large single center study of initial characteristics, natural history, and prognostic factors

et al. 2009

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“…1 The incidence of CNS dissemination varies widely by lymphoma histology, ranging from 5% in patients with diffuse large B-cell lymphoma (DLBCL) to 30% in those diagnosed with Burkitt's lymphoma. 1,2 Treatment of SCNSL usually relies on high doses of methotrexate, but relapses are frequent and salvage strategies are scarce. 3 SCNSL has a dismal prognosis, with an overall survival (OS) of less than 6 months.…”

mentioning

confidence: 99%

“…3 SCNSL has a dismal prognosis, with an overall survival (OS) of less than 6 months. [1][2][3] Exportin 1 (XPO-1) mediates the nuclear export of many regulatory proteins including tumor suppressors, and it is overexpressed in many cancers including hematological malignancies.…”

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confidence: 99%

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Promising activity of selinexor in the treatment of a patient with refractory diffuse large B-cell lymphoma and central nervous system involvement

et al. 2017

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“…Some reports have suggested that a high-dose intravenous rituximab infusion or intrathecal rituximab infusion may be an effective treatment option [13], although the clinical safety of such treatments has not been yet been confirmed. In order to prevent CNS recurrence of DLBCL, intrathecal chemotherapy such as MTX and cytarabine is currently performed in many institutions, although its efficacy has been controversial [2,[14][15][16][17][18]. Kim et al described the treatment of 73 DLBCL patients with secondary CNS involvement in 11 institutions in Korea [14].…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Elderly Diffuse Large B-Cell Lymphoma with Central Nervous System Recurrence by Rituximab, Ranimusutine, Ifosfamide, Procarbazine, Dexamethasone, and Etoposide Therapy

Miyahara¹,

Takezako²,

Wagatsuma³

et al. 2013

JCT

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The prognosis of CD20-positive (CD20+) diffuse large B-cell lymphoma (DLBCL) with central nervous system (CNS) recurrence is still poor. A standard treatment for CD20+ DLBCL with CNS recurrence in elderly patients has not been established mainly due to adverse effects. We previously reported the efficacy and safety of MIND-E (ranimustine, ifosfamide, procarbazine, dexamethasone, and etoposide) therapy for elderly CD20+ DLBCL patients with CNS recurrence. Here, we report the use of R-MIND-E therapy (rituximab, ranimustine, ifosfamide, procarbazine, dexamethasone and etoposide) in an elderly CD20+ DLBCL patient with CNS recurrence. The patient achieved a complete response according to Revised Response Criteria for Malignant Lymphoma, and treatment-related toxicity was tolerable. R-MIND-E therapy may be a feasible and useful treatment option for elderly CD20+ DLBCL patients with CNS recurrence.

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CNS prophylaxis in lymphoma: Who to target and what therapy to use

Cited by 128 publications

References 142 publications

Primary breast non‐Hodgkin's lymphoma: A large single center study of initial characteristics, natural history, and prognostic factors

Primary breast non‐Hodgkin's lymphoma: A large single center study of initial characteristics, natural history, and prognostic factors

Promising activity of selinexor in the treatment of a patient with refractory diffuse large B-cell lymphoma and central nervous system involvement

Successful Treatment of Elderly Diffuse Large B-Cell Lymphoma with Central Nervous System Recurrence by Rituximab, Ranimusutine, Ifosfamide, Procarbazine, Dexamethasone, and Etoposide Therapy

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