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

Nancy D. Doolittle, Lauren E. Abrey, Tamara N. Shenkier, Tali Siegal, Jacoline E C Bromberg, Edward A. Neuwelt, Carole Soussain, Kristoph Jahnke, Patrick Bruce Johnston, Gerald Illerhaus, David Schiff, Tracy Batchelor, Silvia Montoto, Dale F. Kraemer, Emanuele Zucca

Research output: Contribution to journalArticle

68 Citations (Scopus)

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 frontline 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.

Original languageEnglish (US)
Pages (from-to)1085-1093
Number of pages9
JournalBlood
Volume111
Issue number3
DOIs
StatePublished - 2008

Fingerprint

Neurology
Non-Hodgkin's Lymphoma
Lymphoma
Brain
Central Nervous System
Recurrence
Methotrexate
Survival
Patient treatment
Neuroimaging
Cerebrospinal fluid
Confidence Intervals
Lymphoma, Large B-Cell, Diffuse
Tumors
Brain Neoplasms
Cells
Cerebrospinal Fluid
Therapeutics
Research Personnel

ASJC Scopus subject areas

  • Hematology

Cite this

Brain parenchyma involvement as isolated central nervous system relapse of systemic non-Hodgkin lymphoma : An International Primary CNS Lymphoma Collaborative Group report. / Doolittle, Nancy D.; Abrey, Lauren E.; Shenkier, Tamara N.; Siegal, Tali; Bromberg, Jacoline E C; Neuwelt, Edward A.; Soussain, Carole; Jahnke, Kristoph; Johnston, Patrick Bruce; Illerhaus, Gerald; Schiff, David; Batchelor, Tracy; Montoto, Silvia; Kraemer, Dale F.; Zucca, Emanuele.

In: Blood, Vol. 111, No. 3, 2008, p. 1085-1093.

Research output: Contribution to journalArticle

Doolittle, ND, Abrey, LE, Shenkier, TN, Siegal, T, Bromberg, JEC, Neuwelt, EA, Soussain, C, Jahnke, K, Johnston, PB, Illerhaus, G, Schiff, D, Batchelor, T, Montoto, S, Kraemer, DF & Zucca, E 2008, 'Brain parenchyma involvement as isolated central nervous system relapse of systemic non-Hodgkin lymphoma: An International Primary CNS Lymphoma Collaborative Group report', Blood, vol. 111, no. 3, pp. 1085-1093. https://doi.org/10.1182/blood-2007-07-101402
Doolittle, Nancy D. ; Abrey, Lauren E. ; Shenkier, Tamara N. ; Siegal, Tali ; Bromberg, Jacoline E C ; Neuwelt, Edward A. ; Soussain, Carole ; Jahnke, Kristoph ; Johnston, Patrick Bruce ; Illerhaus, Gerald ; Schiff, David ; Batchelor, Tracy ; Montoto, Silvia ; Kraemer, Dale F. ; Zucca, Emanuele. / Brain parenchyma involvement as isolated central nervous system relapse of systemic non-Hodgkin lymphoma : An International Primary CNS Lymphoma Collaborative Group report. In: Blood. 2008 ; Vol. 111, No. 3. pp. 1085-1093.
@article{4b74c82590f54c28b2bb26e9921369e0,
title = "Brain parenchyma involvement as isolated central nervous system relapse of systemic non-Hodgkin lymphoma: An International Primary CNS Lymphoma Collaborative Group report",
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 frontline 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.",
author = "Doolittle, {Nancy D.} and Abrey, {Lauren E.} and Shenkier, {Tamara N.} and Tali Siegal and Bromberg, {Jacoline E C} and Neuwelt, {Edward A.} and Carole Soussain and Kristoph Jahnke and Johnston, {Patrick Bruce} and Gerald Illerhaus and David Schiff and Tracy Batchelor and Silvia Montoto and Kraemer, {Dale F.} and Emanuele Zucca",
year = "2008",
doi = "10.1182/blood-2007-07-101402",
language = "English (US)",
volume = "111",
pages = "1085--1093",
journal = "Blood",
issn = "0006-4971",
publisher = "American Society of Hematology",
number = "3",

}

TY - JOUR

T1 - Brain parenchyma involvement as isolated central nervous system relapse of systemic non-Hodgkin lymphoma

T2 - An International Primary CNS Lymphoma Collaborative Group report

AU - Doolittle, Nancy D.

AU - Abrey, Lauren E.

AU - Shenkier, Tamara N.

AU - Siegal, Tali

AU - Bromberg, Jacoline E C

AU - Neuwelt, Edward A.

AU - Soussain, Carole

AU - Jahnke, Kristoph

AU - Johnston, Patrick Bruce

AU - Illerhaus, Gerald

AU - Schiff, David

AU - Batchelor, Tracy

AU - Montoto, Silvia

AU - Kraemer, Dale F.

AU - Zucca, Emanuele

PY - 2008

Y1 - 2008

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 frontline 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.

AB - 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 frontline 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.

UR - http://www.scopus.com/inward/record.url?scp=38949211479&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=38949211479&partnerID=8YFLogxK

U2 - 10.1182/blood-2007-07-101402

DO - 10.1182/blood-2007-07-101402

M3 - Article

C2 - 17962515

AN - SCOPUS:38949211479

VL - 111

SP - 1085

EP - 1093

JO - Blood

JF - Blood

SN - 0006-4971

IS - 3

ER -