Central nervous system involvement in mantle cell lymphoma
Open Access
- 24 October 2007
- journal article
- research article
- Published by Elsevier BV in Annals Of Oncology
- Vol. 19 (1), 135-141
- https://doi.org/10.1093/annonc/mdm447
Abstract
Background: Extranodal involvement, including central nervous system (CNS), is a frequent event in patients with mantle cell lymphoma (MCL). However, the incidence, risk factors, and impact on outcome remain controversial. Patients and methods: Main clinical, biological, and evolutive features of 82 patients (60 males/22 females; median age: 61 years) diagnosed with MCL (blastoid, 26%) in a single institution were analyzed for risk of CNS involvement and prognosis. Results: Most patients had advanced stage and intermediate or high-risk International Prognostic Index (IPI). Eleven patients eventually developed CNS involvement with an actuarial 5-year risk of 26% (95% confidence interval 10% to 42%). In one asymptomatic patient, cerebrospinal fluid infiltration was detected at staging maneuvers (1/62; 1.6%). The remaining 10 patients developed neurological symptoms during the course of the disease (median time from diagnosis, 25 months). Initial variables predicting CNS involvement were blastoid histology, high proliferative index measured by Ki-67 staining, high lactate dehydrogenase (LDH) and intermediate- or high-risk IPI. Histological subtype and serum LDH maintained significance in multivariate analysis. Treatment of CNS infiltration consisted of intrathecal chemotherapy (two cases), and intrathecal chemotherapy plus systemic treatment (seven cases). Median survival after CNS involvement was 4.8 months, patients with this complication having shorter survival than those with no CNS disease. Conclusion: This study confirms the high incidence of CNS involvement in MCL patients. Treatments aimed at preventing this complication are warranted.This publication has 27 references indexed in Scilit:
- Current Treatment Approaches for Mantle-Cell LymphomaJournal of Clinical Oncology, 2005
- Retrospective study of prognostic factors in non-Hodgkin lymphoma secondarily involving the central nervous systemAnnals of Hematology, 2005
- Secondary Central Nervous System Lymphoma: Risk Factors and ProphylaxisHematology/Oncology Clinics of North America, 2005
- Cerebrospinal Fluid Involvement in Mantle Cell LymphomaLaboratory Investigation, 2002
- Mantle cell lymphoma. A clinicopathologic study of 68 cases from the Nebraska Lymphoma Study GroupAmerican Journal of Hematology, 2000
- Central Nervous System Relapse in Non-Hodgkin LymphomaArchives of Neurology, 1997
- Expression of LFA-1/ICAM-1 in CNS lymphomas: possible mechanism for lymphoma homing into the brainJournal of Neuro-Oncology, 1992
- Central Nervous System Involvement in Patients with Diffuse Aggressive Non-Hodgkinʼs LymphomaAmerican Journal of Clinical Oncology, 1991
- Evaluation of Response-Time Data Involving Transient States: An Illustration Using Heart-Transplant DataJournal of the American Statistical Association, 1974
- Nonparametric Estimation from Incomplete ObservationsJournal of the American Statistical Association, 1958