Central nervous system involvement in mantle cell lymphoma.
Ann Oncol
; 19(1): 135-41, 2008 Jan.
Article
en En
| MEDLINE
| ID: mdl-17962207
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 ANDMETHODS:
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.
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Banco de datos:
MEDLINE
Asunto principal:
Sistema Nervioso Central
/
Linfoma de Células del Manto
Tipo de estudio:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Año:
2008
Tipo del documento:
Article