Final results of a multicenter trial addressing role of CSF flow cytometric analysis in NHL patients at high risk for CNS dissemination

被引：65

作者：

Benevolo, Giulia ^{[4
]}

Stacchini, Alessandra ^{[1
,2
]}

Spina, Michele

Ferreri, Andres J. M. ^{[3
]}

Arras, Marcella ^{[5
]}

Bellio, Laura ^{[6
]}

Botto, Barbara ^{[4
]}

Bulian, Pietro

Cantonetti, Maria ^{[7
]}

Depaoli, Lorella ^{[8
]}

Di Renzo, Nicola ^{[9
]}

Di Rocco, Alice ^{[10
]}

Evangelista, Andrea ^{[11
]}

Franceschetti, Silvia ^{[12
]}

Godio, Laura ^{[1
,2
]}

Mannelli, Francesco ^{[13
]}

Pavone, Vincenzo ^{[14
]}

Pioltelli, Pietro ^{[15
]}

Vitolo, Umberto ^{[4
]}

Pogliani, Enrico M. ^{[15
]}

机构：

[1] Pathol Inst Univ, Turin, Italy

[2] Natl Canc Inst, Div Med Oncol A, Aviano, Italy

[3] Ist Sci San Raffaele, Dept Onco Haematol, Unit Lymphoid Malignancies, I-20132 Milan, Italy

[4] Haematol 2 Azienda Osped Citta Salute & Sci, Turin, Italy

[5] Div Haematol, Cagliari, Italy

[6] Ist Sci San Raffaele, Serv Med Transfus & Hematol, I-20132 Milan, Italy

[7] Univ Roma Tor Vergata, Haematol Inst, Rome, Italy

[8] Div Haematol, Alessandria, Italy

[9] Div Haematol, Lecce, Italy

[10] Univ Roma La Sapienza, Haematol Inst, Rome, Italy

[11] Azienda Osped Citta Salute & Sci, Ctr Prevenz Oncol Piemonte, Turin, Italy

[12] Amedeo Avogadro Univ, Div Haematol, Novara, Italy

[13] Haematol Inst Univ, Florence, Italy

[14] Div Haematol, Tricase, Italy

[15] Haematol Inst Univ, Monza, Italy

来源：

BLOOD | 2012年 / 120卷 / 16期

关键词：

B-CELL LYMPHOMA; NON-HODGKINS-LYMPHOMA; NERVOUS-SYSTEM INVOLVEMENT; MABTHERA INTERNATIONAL TRIAL; CHEMOTHERAPY PLUS RITUXIMAB; RANDOMIZED CONTROLLED-TRIAL; CEREBROSPINAL-FLUID; LEPTOMENINGEAL DISEASE; CHOP CHEMOTHERAPY; ELDERLY-PATIENTS;

D O I：

10.1182/blood-2012-04-423095

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

This prospective study compared diagnostic and prognostic value of conventional cytologic (CC) examination and flow cytometry (FCM) of baseline samples of cerebrospinal fluid (CSF) in 174 patients with newly diagnosed aggressive non-Hodgkin lymphoma (NHL). FCM detected a neoplastic population in the CSF of 18 of 174 patients (10%), CC only in 7 (4%; P < .001); 11 patients (14%) were discordant (FCM+/CC-). At a median follow-up of 46 months, there were 64 systemic progressions and 10 CNS relapses, including 2 patients with both systemic and CNS relapses. Two-year progression-free and overall survival were significantly higher in patients with FCM- CSF (62% and 72%) compared with those FCM- CSF (39% and 50%, respectively), with a 2-year CNS relapse cumulative incidence of 3% (95% confidence interval [CI], 0-7) versus 17% (95% CI, 0-34; P = .004), respectively. The risk of CNS progression was significantly higher in FMC+/CC- versus FCM+/CC- patients (hazard ratio = 8.16, 95% CI, 1.45-46). In conclusion, FCM positivity in the CSF of patients with high-risk NHL is associated with a significantly higher CNS relapse risk and poorer outcome. The combination of IV drugs with a higher CNS bioavailability and intrathecal chemotherapy is advisable to prevent CNS relapses in FCM+ patients. (Blood. 2012;120(16):3222-3228)

引用

页码：3222 / 3228

页数：7

共 43 条

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