BACKGROUND: Malignant lymphoma with central nervous system (CNS) involvement has an extremely poor prognosis. We retrospectively studied the risk factors for CNS involvement in patients with diffuse large B-cell lymphoma (DLBCL) treated by cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or rituximab (R) -CHOP chemotherapy. PATIENTS AND METHODS: We studied 375 consecutive patients who were newly diagnosed with DLBCL between 1996 and 2006. Patients with primary CNS involvement and patients who received CNS prophylaxis were excluded. All the patients received CHOP (n = 172) or R-CHOP (n = 203) chemotherapy. The following variables were assessed for their potential to predict CNS involvement: gender, age, serum lactate dehydrogenase (LDH) level, performance status, clinical stage, number of extranodal involvements, International Prognostic Index (IPI), bone marrow involvement, presence of a bulky mass, presence of B symptom, and treatment. RESULTS: CNS involvement was observed in 13 cases (3.5%). In univariate analysis, LDH more than normal range, LDH more than twice as normal range, high IPI, bone marrow involvement, and systemic relapse were the predictors for CNS involvement. In multivariate analysis, no risk factors were detected for CNS involvement. The use of rituximab did not have an impact on CNS involvement. CONCLUSIONS: The incidence of CNS involvement does not decrease in rituximab-era.
BACKGROUND:Malignant lymphoma with central nervous system (CNS) involvement has an extremely poor prognosis. We retrospectively studied the risk factors for CNS involvement in patients with diffuse large B-cell lymphoma (DLBCL) treated by cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or rituximab (R) -CHOP chemotherapy. PATIENTS AND METHODS: We studied 375 consecutive patients who were newly diagnosed with DLBCL between 1996 and 2006. Patients with primary CNS involvement and patients who received CNS prophylaxis were excluded. All the patients received CHOP (n = 172) or R-CHOP (n = 203) chemotherapy. The following variables were assessed for their potential to predict CNS involvement: gender, age, serum lactate dehydrogenase (LDH) level, performance status, clinical stage, number of extranodal involvements, International Prognostic Index (IPI), bone marrow involvement, presence of a bulky mass, presence of B symptom, and treatment. RESULTS: CNS involvement was observed in 13 cases (3.5%). In univariate analysis, LDH more than normal range, LDH more than twice as normal range, high IPI, bone marrow involvement, and systemic relapse were the predictors for CNS involvement. In multivariate analysis, no risk factors were detected for CNS involvement. The use of rituximab did not have an impact on CNS involvement. CONCLUSIONS: The incidence of CNS involvement does not decrease in rituximab-era.
Authors: Francisco-Javier Peñalver; Juan-Manuel Sancho; Adolfo de la Fuente; María-Teresa Olave; Alejandro Martín; Carlos Panizo; Elena Pérez; Antonio Salar; Alberto Orfao Journal: Haematologica Date: 2016-10-20 Impact factor: 9.941
Authors: Rosa Bosch; María José Moreno; Rebeca Dieguez-Gonzalez; María Virtudes Céspedes; Alberto Gallardo; Manuel Trias; Albert Grañena; Jorge Sierra; Isolda Casanova; Ramon Mangues Journal: Haematologica Date: 2013-05-28 Impact factor: 9.941
Authors: Cigall Kadoch; Jing Li; Valerie S Wong; Lingjing Chen; Soonmee Cha; Pamela Munster; Clifford A Lowell; Marc A Shuman; James L Rubenstein Journal: Clin Cancer Res Date: 2013-11-04 Impact factor: 12.531