How I treat patients with aggressive lymphoma at high risk of CNS relapse

被引:23
作者
Chin, Collin K. [1 ,2 ]
Cheah, Chan Yoon [1 ,2 ,3 ]
机构
[1] Sir Charles Gairdner Hosp, Dept Haematol, Ground Floor,B Block,Hosp Ave, Nedlands, WA 6009, Australia
[2] Pathwest Lab Med WA, Nedlands, WA, Australia
[3] Univ Western Australia, Med Sch, Crawley, WA, Australia
关键词
B-CELL LYMPHOMA; NON-HODGKINS-LYMPHOMA; NERVOUS-SYSTEM PROPHYLAXIS; SPINAL-CORD COMPRESSION; DOUBLE-HIT LYMPHOMA; PROGNOSTIC-FACTORS; RITUXIMAB-CHOP; FOLLOW-UP; INTRATHECAL CHEMOTHERAPY; RETROSPECTIVE ANALYSIS;
D O I
10.1182/blood-2017-03-737460
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Central nervous system (CNS) relapses are an uncommon yet devastating complication of non-Hodgkin lymphomas. The identification of patients at high risk of secondary CNS relapse is therefore paramount. Retrospective data indicate prophylactic CNS-directed therapies may reduce the risk of CNS involvement; however, no consensus exists about dose, timing, or route of therapy. In addition, prophylaxis is not without risk of treatment-related complications and morbidity. Here, we present a series of case vignettes highlighting our approach to common dilemmas encountered in routine clinical practice. We review the method of assessing CNS relapse risk, factors that increase the likelihood of relapse including histologic subtype, MYC rearrangement, protein expression, and extranodal involvement, and review our clinical practice based on available evidence in administering CNS-directed prophylaxis.
引用
收藏
页码:867 / 874
页数:8
相关论文
共 92 条
  • [1] Intravenous Methotrexate as Central Nervous System (CNS) Prophylaxis Is Associated With a Low Risk of CNS Recurrence in High-Risk Patients With Diffuse Large B-Cell Lymphoma
    Abramson, Jeremy S.
    Hellmann, Matthew
    Barnes, Jeffrey A.
    Hammerman, Peter
    Toomey, Christiana
    Takvorian, Tak
    Muzikansky, Alona
    Hochberg, Ephraim P.
    [J]. CANCER, 2010, 116 (18) : 4283 - 4290
  • [2] [Anonymous], 2014, BLOOD
  • [3] [Anonymous], 2016, BLOOD
  • [4] The role of intrathecal chemotherapy prophylaxis in patients with diffuse large B-cell lymphoma
    Arkenau, H. -T.
    Chong, G.
    Cunningham, D.
    Watkins, D.
    Agarwal, R.
    Sirohi, B.
    Trumper, M.
    Norman, A.
    Wotherspoon, A.
    Horwich, A.
    [J]. ANNALS OF ONCOLOGY, 2007, 18 (03) : 541 - 545
  • [5] Ayed AO, 2016, P AM SOC HEM 58 ANN
  • [6] Rearrangement of MYC Is Associated With Poor Prognosis in Patients With Diffuse Large B-Cell Lymphoma Treated in the Era of Rituximab
    Barrans, Sharon
    Crouch, Simon
    Smith, Alex
    Turner, Kathryn
    Owen, Roger
    Patmore, Russell
    Roman, Eve
    Jack, Andrew
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 2010, 28 (20) : 3360 - 3365
  • [7] Treatment of primary CNS lymphoma with methotrexate and deferred radiotherapy: A report of NABTT 96-07
    Batchelor, T
    Carson, K
    O'Neill, A
    Grossman, SA
    Alavi, J
    New, P
    Hochberg, F
    Priet, R
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 2003, 21 (06) : 1044 - 1049
  • [8] Final results of a multicenter trial addressing role of CSF flow cytometric analysis in NHL patients at high risk for CNS dissemination
    Benevolo, Giulia
    Stacchini, Alessandra
    Spina, Michele
    Ferreri, Andres J. M.
    Arras, Marcella
    Bellio, Laura
    Botto, Barbara
    Bulian, Pietro
    Cantonetti, Maria
    Depaoli, Lorella
    Di Renzo, Nicola
    Di Rocco, Alice
    Evangelista, Andrea
    Franceschetti, Silvia
    Godio, Laura
    Mannelli, Francesco
    Pavone, Vincenzo
    Pioltelli, Pietro
    Vitolo, Umberto
    Pogliani, Enrico M.
    [J]. BLOOD, 2012, 120 (16) : 3222 - 3228
  • [9] Activity of ibrutinib in mantle cell lymphoma patients with central nervous system relapse
    Bernard, Sophie
    Goldwirt, Lauriane
    Amorim, Sandy
    Brice, Pauline
    Briere, Josette
    de Kerviler, Eric
    Mourah, Samia
    Sauvageon, Helene
    Thieblemont, Catherine
    [J]. BLOOD, 2015, 126 (14) : 1695 - 1698
  • [10] Natural History of CNS Relapse in Patients With Aggressive Non-Hodgkin's Lymphoma: A 20-Year Follow-Up Analysis of SWOG 8516-The Southwest Oncology Group
    Bernstein, Steven H.
    Unger, Joseph M.
    LeBlanc, Michael
    Friedberg, Jonathan
    Miller, Thomas P.
    Fisher, Richard I.
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 2009, 27 (01) : 114 - 119