Brain parenchyma involvement as isolated central nervous system relapse of systemic non-Hodgkin lymphoma: an International Primary CNS Lymphoma Collaborative Group report Export

@article{citeulike:2580739, abstract = {Isolated central nervous system (CNS) relapse involving the brain parenchyma is a rare complication of systemic non-Hodgkin lymphoma. We retrospectively analyzed patient characteristics, management, and outcomes of this complication. After complete response to initial non-Hodgkin lymphoma treatment, patients with isolated CNS relapse with the brain parenchyma as initial relapse site were eligible. Patients with isolated CNS relapse involving only the cerebrospinal fluid were not eligible. Information on 113 patients was assembled from 13 investigators; 94 (83\%) had diffuse large B-cell lymphoma. Median time to brain relapse was 1.8 years (range, 0.25-15.9 years). Brain relapse was identified by neuroimaging in all patients; in 54 (48\%), diagnostic brain tumor specimen was obtained. Median overall survival from date of brain relapse was 1.6 years (95\% confidence interval, 0.9-2.6 years); 26 (23\%) have survived 3 years or more. Median time to progression was 1.0 year (95\% confidence interval, 0.7-1.7 years). Age less than 60 years (P = .006) at relapse and methotrexate use (P = .008) as front-line treatment for brain relapse were significantly associated with longer survival in a multivariate model. Our results suggest systemic methotrexate is the optimal treatment for isolated CNS relapse involving the brain parenchyma. Long-term survival is possible in some patients. 10.1182/blood-2007-07-101402}, author = {Doolittle, Nancy D. and Abrey, Lauren E. and Shenkier, Tamara N. and Tali, Siegal and Bromberg, Jacoline E. and Neuwelt, Edward A. and Soussain, Carole and Jahnke, Kristoph and Johnston, Patrick and Illerhaus, Gerald and Schiff, David and Batchelor, Tracy and Montoto, Silvia and Kraemer, Dale F. and Zucca, Emanuele}, citeulike-article-id = {2580739}, citeulike-linkout-0 = {http://dx.doi.org/10.1182/blood-2007-07-101402}, citeulike-linkout-1 = {http://bloodjournal.hematologylibrary.org/cgi/content/abstract/111/3/1085}, citeulike-linkout-2 = {http://view.ncbi.nlm.nih.gov/pubmed/17962515}, citeulike-linkout-3 = {http://www.hubmed.org/display.cgi?uids=17962515}, day = {1}, doi = {10.1182/blood-2007-07-101402}, journal = {Blood}, keywords = {lymphoma, neuro}, month = {February}, number = {3}, pages = {1085--1093}, posted-at = {2008-03-24 14:30:40}, priority = {2}, title = {Brain parenchyma involvement as isolated central nervous system relapse of systemic non-Hodgkin lymphoma: an International Primary CNS Lymphoma Collaborative Group report}, url = {http://dx.doi.org/10.1182/blood-2007-07-101402}, volume = {111}, year = {2008} }

TY - JOUR ID - citeulike:2580739 L3 - citeulike-article-id:2580739 N2 - Isolated central nervous system (CNS) relapse involving the brain parenchyma is a rare complication of systemic non-Hodgkin lymphoma. We retrospectively analyzed patient characteristics, management, and outcomes of this complication. After complete response to initial non-Hodgkin lymphoma treatment, patients with isolated CNS relapse with the brain parenchyma as initial relapse site were eligible. Patients with isolated CNS relapse involving only the cerebrospinal fluid were not eligible. Information on 113 patients was assembled from 13 investigators; 94 (83%) had diffuse large B-cell lymphoma. Median time to brain relapse was 1.8 years (range, 0.25-15.9 years). Brain relapse was identified by neuroimaging in all patients; in 54 (48%), diagnostic brain tumor specimen was obtained. Median overall survival from date of brain relapse was 1.6 years (95% confidence interval, 0.9-2.6 years); 26 (23%) have survived 3 years or more. Median time to progression was 1.0 year (95% confidence interval, 0.7-1.7 years). Age less than 60 years (P = .006) at relapse and methotrexate use (P = .008) as front-line treatment for brain relapse were significantly associated with longer survival in a multivariate model. Our results suggest systemic methotrexate is the optimal treatment for isolated CNS relapse involving the brain parenchyma. Long-term survival is possible in some patients. 10.1182/blood-2007-07-101402 IS - 3 JF - Blood EP - 1093 TI - Brain parenchyma involvement as isolated central nervous system relapse of systemic non-Hodgkin lymphoma: an International Primary CNS Lymphoma Collaborative Group report VL - 111 SP - 1085 KW - lymphoma KW - neuro AU - Doolittle, Nancy AU - Abrey, Lauren AU - Shenkier, Tamara AU - Tali, Siegal AU - Bromberg, Jacoline AU - Neuwelt, Edward AU - Soussain, Carole AU - Jahnke, Kristoph AU - Johnston, Patrick AU - Illerhaus, Gerald AU - Schiff, David AU - Batchelor, Tracy AU - Montoto, Silvia AU - Kraemer, Dale AU - Zucca, Emanuele PY - 2008/02/01/ UR - http://dx.doi.org/10.1182/blood-2007-07-101402 ER -