PURPOSE: CNS involvement of non-Hodgkin's lymphoma (NHL) has always been considered a poor prognostic factor in relation to survival with conventional therapy. However, its effect on the outcome of autologous bone marrow transplantation (ABMT) has not been assessed. We examined this using data from the European Bone Marrow Transplant (EBMT) Lymphoma Registry. PATIENTS AND METHODS: One thousand four hundred sixty-four patients with NHL have been reported to the EBMT registry, of whom 62 had CNS involvement. Patients were divided into those who were clear of CNS disease at the time of ABMT and those who were not. Response, complications, and outcome to ABMT were analyzed, as were details of CNS diagnosis, treatment, and prophylaxis. RESULTS: Status at transplant was the only factor that significantly affected outcome of ABMT on univariate analysis (P = .03). The progression-free survival (PFS) rate of the group that had no CNS involvement at ABMT was 42% at 5 years, compared with 27% in a group of stage IV NHL patients without CNS disease (matched for status at transplant and histology). There were four of 45 (8.9%) toxic deaths. The PFS rate of the group that had CNS involvement at ABMT was 9% at a median follow-up time of 71 months, which was significantly different (P = .001) from that of the other group. There were five of 17 (29.4%) toxic deaths (P = .043). Patients who had CNS involvement at diagnosis, as compared with relapse, and those treated with both intrathecal chemotherapy and irradiation had a better outcome. CONCLUSION: The presence of CNS disease before ABMT but not present at transplant does not adversely affect the outcome of ABMT. In contrast, patients with CNS involvement at the time of ABMT have a poor prognosis, although a small number survive in complete remission (CR).
PURPOSE: CNS involvement of non-Hodgkin's lymphoma (NHL) has always been considered a poor prognostic factor in relation to survival with conventional therapy. However, its effect on the outcome of autologous bone marrow transplantation (ABMT) has not been assessed. We examined this using data from the European Bone Marrow Transplant (EBMT) Lymphoma Registry. PATIENTS AND METHODS: One thousand four hundred sixty-four patients with NHL have been reported to the EBMT registry, of whom 62 had CNS involvement. Patients were divided into those who were clear of CNS disease at the time of ABMT and those who were not. Response, complications, and outcome to ABMT were analyzed, as were details of CNS diagnosis, treatment, and prophylaxis. RESULTS: Status at transplant was the only factor that significantly affected outcome of ABMT on univariate analysis (P = .03). The progression-free survival (PFS) rate of the group that had no CNS involvement at ABMT was 42% at 5 years, compared with 27% in a group of stage IV NHLpatients without CNS disease (matched for status at transplant and histology). There were four of 45 (8.9%) toxic deaths. The PFS rate of the group that had CNS involvement at ABMT was 9% at a median follow-up time of 71 months, which was significantly different (P = .001) from that of the other group. There were five of 17 (29.4%) toxic deaths (P = .043). Patients who had CNS involvement at diagnosis, as compared with relapse, and those treated with both intrathecal chemotherapy and irradiation had a better outcome. CONCLUSION: The presence of CNS disease before ABMT but not present at transplant does not adversely affect the outcome of ABMT. In contrast, patients with CNS involvement at the time of ABMT have a poor prognosis, although a small number survive in complete remission (CR).
Authors: Jacoline E Bromberg; Jeanette K Doorduijn; Gerald Illerhaus; Kristoph Jahnke; Agniezka Korfel; Lars Fischer; Kristina Fritsch; Outti Kuittinen; Samar Issa; Cees van Montfort; Martin J van den Bent Journal: Haematologica Date: 2012-11-09 Impact factor: 9.941
Authors: Richard T Maziarz; Zhiwei Wang; Mei-Jie Zhang; Brian J Bolwell; Andy I Chen; Timothy S Fenske; Cesar O Freytes; Robert P Gale; John Gibson; Brandon M Hayes-Lattin; Leona Holmberg; David J Inwards; Luis M Isola; Hanna J Khoury; Victor A Lewis; Dipnarine Maharaj; Reinhold Munker; Gordon L Phillips; David A Rizzieri; Philip A Rowlings; Wael Saber; Prakash Satwani; Edmund K Waller; David G Maloney; Silvia Montoto; Ginna G Laport; Julie M Vose; Hillard M Lazarus; Parameswaran N Hari Journal: Br J Haematol Date: 2013-07-06 Impact factor: 6.998
Authors: Agnieszka Korfel; Thomas Elter; Eckhard Thiel; Matthias Hänel; Robert Möhle; Roland Schroers; Marcel Reiser; Martin Dreyling; Jan Eucker; Christian Scholz; Bernd Metzner; Alexander Röth; Josef Birkmann; Uwe Schlegel; Peter Martus; Gerard Illerhaus; Lars Fischer Journal: Haematologica Date: 2012-12-14 Impact factor: 9.941
Authors: Yi-Bin Chen; Tracy Batchelor; Shuli Li; Ephraim Hochberg; Mark Brezina; Sooae Jones; Candice Del Rio; Morgan Curtis; Karen K Ballen; Jeffrey Barnes; Andrew S Chi; Jorg Dietrich; Jessica Driscoll; Elizabeth R Gertsner; Fred Hochberg; Ann S LaCasce; Steven L McAfee; Thomas R Spitzer; Lakshmi Nayak; Philippe Armand Journal: Cancer Date: 2014-09-09 Impact factor: 6.860
Authors: Patricia A Young; Daria Gaut; Davis K Kimaiyo; Jonathan Grotts; Tahmineh Romero; John Chute; Gary Schiller; Sven de Vos; Herbert A Eradat; John Timmerman Journal: Clin Lymphoma Myeloma Leuk Date: 2020-02-20