Long‐term survival with favorable cognitive outcome after chemotherapy in primary central nervous system lymphoma

Juergens, Annika; Pels, Hendrik; Rogowski, Sabine; Fließbach, Klaus; Glasmacher, Axel; Engert, Andreas; Reiser, Marcel; Diehl, Volker; Vogt‐Schaden, Marlies; Egerer, Gerlinde; Schackert, Gabriele; Reichmann, Heinz; Kroschinsky, Frank; Bode, Udo; Herrlinger, Ulrich; Linnebank, Michael; Deckert, Martina; Fimmers, Rolf; Schmidt‐Wolf, Ingo G.H.; Schlegel, Uwe

doi:10.1002/ana.21824

Cited by 111 publications

(68 citation statements)

References 30 publications

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“…18 Age was, however, not found to be a risk factor in a recently published Cancer and Leukemia Group B (CALGB) study in which 44 patients with median age of 61 years (12-76 years) were treated with HD-MTX, rituximab and TZM induction followed by etoposide and HD-AraC consolidation without CSFtargeted chemotherapy. 19 The median PFS in the CALGB cohort was similar in older and younger patients.…”

Section: Discussionmentioning

confidence: 99%

Successful change of treatment strategy in elderly patients with primary central nervous system lymphoma by de-escalating induction and introducing temozolomide maintenance: results from a phase II study by The Nordic Lymphoma Group

et al. 2014

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Section: Discussionmentioning

confidence: 99%

Successful change of treatment strategy in elderly patients with primary central nervous system lymphoma by de-escalating induction and introducing temozolomide maintenance: results from a phase II study by The Nordic Lymphoma Group

et al. 2014

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“…Current efforts to improve outcome in PCNSL explore various options, including (1) HDMTX-based polychemotherapy with intrathecal chemotherapy, [33][34][35] (2) HDMTXbased polychemotherapy plus blood-brain barrier disruption 36 and (3) HDMTX-based polychemotherapy followed by autologous stem cell transplantation with or without adjuvant radiotherapy. [37][38] A more puristic approach would try to improve on the results obtained with HDMTX alone by combining HDMTX with another chemotherapeutic drug instead of WBRT, e.g., with HD-Ara-C 19 or with ifosfamide as done here.…”

Section: Discussionmentioning

confidence: 99%

High-dose methotrexate with or without whole brain radiotherapy for primary CNS lymphoma (G-PCNSL-SG-1): a phase 3, randomised, non-inferiority trial

Thiel

Korfel

Martus

et al. 2010

The Lancet Oncology

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“…1 Because PCNSLs represent highly aggressive tumors, early diagnosis is essential for successful treatment and improvement of disease prognosis. 1,[3][4][5] Although evaluation of the cerebrospinal fluid (CSF) is less invasive than brain biopsy, cytopathologic, immunophenotypic, and genetic analyses of CSF cells are much less sensitive. [6][7][8] Protein markers within the CSF include antithrombin, 9 soluble CD27, 10 and free immunoglobulin light chains.…”

Section: Introductionmentioning

confidence: 99%

Identification of microRNAs in the cerebrospinal fluid as marker for primary diffuse large B-cell lymphoma of the central nervous system

Baraniskin

Kuhnhenn

Schlegel

et al. 2011

Blood

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The diagnosis of primary central nervous system lymphoma (PCNSL) depends on histopathology of brain biopsies, because disease markers in the cerebrospinal fluid (CSF) with sufficient diagnostic accuracy are not available yet. MicroRNAs (miRNAs) are regulatory RNA molecules that are deregulated in many disease types, including cancer. Recently, miRNAs have shown promise as markers for cancer diagnosis. In this study, we demonstrate that miRNAs are present in the CSF of patients with PCNSL. With a candidate approach and miRNA quantification by reverse transcription polymerase chain reaction, miRNAs with significant levels in the CSF of patients with PCNSL were identified. MiR-21, miR-19, and miR-92a levels in CSF collected from patients with PCNSL and from controls with inflammatory CNS disorders and other neurologic disorders indicated a significant diagnostic value of this method. Receiveroperating characteristic analyses showed area under the curves of 0.94, 0.98, and 0.97, respectively, for miR-21, miR-19, and miR-92a CSF levels in discriminating PCNSL from controls. More importantly, combined miRNA analyses resulted in an increased diagnostic accuracy with 95.7% sensitivity and 96.7% specificity. We also demonstrated a remarkable stability of miRNAs in the CSF. In conclusion, CSF miRNAs are potentially useful tools as novel noninvasive biomarker for the diagnosis of PCNSL. (Blood. 2011;117(11):3140-3146) IntroductionUnraveling the cause of focal brain lesions in patients with unexplained neurologic symptoms remains a clinical challenge. Especially in patients with primary central nervous system lymphoma (PCNSL), definitive diagnosis often is not possible on the basis of radiographic features and responsiveness to corticosteroids, which both do not specifically distinguish between lymphoma and inflammatory central nervous system (CNS) disease. 1,2 In most patients with suspected CNS lymphoma who present with rapidly deteriorating neurologic symptoms, stereotactic brain biopsy remains the diagnostic procedure of choice. However, CNS biopsies are associated with the risk of hemorrhage and neurologic damage, and a definitive histopathologic diagnosis cannot always be achieved. 1 Because PCNSLs represent highly aggressive tumors, early diagnosis is essential for successful treatment and improvement of disease prognosis. 1,[3][4][5] Although evaluation of the cerebrospinal fluid (CSF) is less invasive than brain biopsy, cytopathologic, immunophenotypic, and genetic analyses of CSF cells are much less sensitive. [6][7][8] Protein markers within the CSF include antithrombin, 9 soluble CD27, 10 and free immunoglobulin light chains. 11 They have been shown to be helpful with improved diagnostic sensitivities; however, their utility in accurate diagnosis of PCNSL from the CSF has not finally been established. 1 MicroRNAs (miRNAs) are small regulatory RNA molecules that bind the 3Ј-untranslated regions of mRNA transcripts and inhibit gene expression at a posttranscriptional level by interference with translational initia...

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Long‐term survival with favorable cognitive outcome after chemotherapy in primary central nervous system lymphoma

Cited by 111 publications

References 30 publications

Successful change of treatment strategy in elderly patients with primary central nervous system lymphoma by de-escalating induction and introducing temozolomide maintenance: results from a phase II study by The Nordic Lymphoma Group

Successful change of treatment strategy in elderly patients with primary central nervous system lymphoma by de-escalating induction and introducing temozolomide maintenance: results from a phase II study by The Nordic Lymphoma Group

High-dose methotrexate with or without whole brain radiotherapy for primary CNS lymphoma (G-PCNSL-SG-1): a phase 3, randomised, non-inferiority trial

Identification of microRNAs in the cerebrospinal fluid as marker for primary diffuse large B-cell lymphoma of the central nervous system

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