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

Abstract

Risk of leptomeningeal disease haematologica | 2014; 99 (7) 1229

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

“…42,[47][48][49][50] More recent analyses of larger series of CSF-stabilized samples using 4-8 color FCM have confirmed the greater sensitivity of FCM vs. CC with a median proportion of occult CNSL (FCM+/CC-CSF) of 12% (range: 5%-13%) ( Table 1). 10,45,51 Patients with occult CNSL (i.e., CC-and FCM+ CSF) typically showed lower levels of CSF infiltration (<20% or <1 tumor B cell/μL) than FCM+/CC+ cases, 45 further supporting the greater sensitivity of FCM vs. CC. These studies 10,45,51 also showed very few false-negative FCM results (range: 0%-<1%), further supporting its greater diagnostic efficiency with respect to CC.…”

“…10,42,45,46 Early studies analyzing non-stabilized CSF samples by ≤4-color FCM already demonstrated increased sensitivity in between 3% and 20% of cases as compared with cytology (Table 2). 42,[47][48][49][50] More recent analyses of larger series of CSF-stabilized samples using 4-8 color FCM have confirmed the greater sensitivity of FCM vs. CC with a median proportion of occult CNSL (FCM+/CC-CSF) of 12% (range: 5%-13%) ( Table 1).…”

“…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.…”

“…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.…”

Safety of liposomal cytarabine CNS prophylaxis in children, adolescent and young adult hematopoietic stem cell transplant recipients with acute leukemia and non-Hodgkin lymphoma

“…The detection of occult leptomeningeal minimal residual disease is possible utilizing flow cytometric techniques and can be a useful tool in identifying those patients who have higher risk of CNS relapse and may benefit from augmented prophylaxis versus those who will not. 11,12 Incorporating liposomal cytarabine into post-HSCT CNS prophylaxis has promise in this regard. With increased utilization both pre-and post HSCT, there will be opportunities to evaluate whether liposomal cytarabine may have a role in either reducing or possibly eliminating the need for cranial boosting during the conditioning regimen prior to HSCT.…”