Detection and outcome of occult leptomeningeal disease in diffuse large B-cell lymphoma and Burkitt lymphoma
Wyndham H. Wilson,
Jacoline E.C. Bromberg,
Maryalice Stetler-Stevenson,
Seth M. Steinberg,
Lourdes Martin-Martin,
Carmen Muñiz,
Juan Manuel Sancho,
Maria Dolores Caballero,
Marjan A. Davidis,
Rik A. Brooimans,
Blanca Sanchez-Gonzalez,
Antonio Salar,
Eva González-Barca,
Jose Maria Ribera,
Margaret Shovlin,
Armando Filie,
Kieron Dunleavy,
Thomas Mehrling,
Michele Spina,
Alberto Orfao
Affiliations
Wyndham H. Wilson
Lymphoid Malignancy Branch, National Cancer Institute, Bethesda, MD, USA
Jacoline E.C. Bromberg
Department of Neuro-Oncology, Daniel den Hoed Cancer Center, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
Maryalice Stetler-Stevenson
Lymphoid Malignancy Branch, National Cancer Institute, Bethesda, MD, USA
Seth M. Steinberg
Lymphoid Malignancy Branch, National Cancer Institute, Bethesda, MD, USA
Lourdes Martin-Martin
Department of Medicine and Centro de Investigacion del Cancer (IBMCC-CSIC/USAL) and Department of Hematology, University Hospital, IBSAL and University of Salamanca, Salamanca, Spain
Carmen Muñiz
Department of Medicine and Centro de Investigacion del Cancer (IBMCC-CSIC/USAL) and Department of Hematology, University Hospital, IBSAL and University of Salamanca, Salamanca, Spain
Juan Manuel Sancho
Department of Hematology, Hospital German Trias i Puyol, University of Barcelona, Spain for the Spanish Group for the Study of CNS Disease in NHL
Maria Dolores Caballero
Department of Medicine and Centro de Investigacion del Cancer (IBMCC-CSIC/USAL) and Department of Hematology, University Hospital, IBSAL and University of Salamanca, Salamanca, Spain
Marjan A. Davidis
Department of Hematology, Daniel den Hoed Cancer Center, Erasmus MC, University Medical Center Rotterdam, The Netherlands
Rik A. Brooimans
Department of Medical Immunology, Daniel den Hoed Cancer Center, Erasmus MC, University Medical Center Rotterdam, The Netherlands
Blanca Sanchez-Gonzalez
Department of Hematology, Hospital del Mar, Barcelona, Spain
Antonio Salar
Department of Hematology, Hospital del Mar, Barcelona, Spain
Eva González-Barca
Department of Hematology, Hospital Duran i Reynals, Institut Catala d’Oncologia, IDIBELL, University of Barcelona, Spain
Jose Maria Ribera
Department of Hematology, Hospital German Trias i Puyol, University of Barcelona, Spain for the Spanish Group for the Study of CNS Disease in NHL
Margaret Shovlin
Lymphoid Malignancy Branch, National Cancer Institute, Bethesda, MD, USA
Armando Filie
Lymphoid Malignancy Branch, National Cancer Institute, Bethesda, MD, USA
Kieron Dunleavy
Lymphoid Malignancy Branch, National Cancer Institute, Bethesda, MD, USA
Thomas Mehrling
Mundipharma International Limited, Cambridge, UK
Michele Spina
Division of Medical Oncology A, National Cancer Institute, Aviano, Italy
Alberto Orfao
Department of Medicine and Centro de Investigacion del Cancer (IBMCC-CSIC/USAL) and Department of Hematology, University Hospital, IBSAL and University of Salamanca, Salamanca, Spain
The benefit of intrathecal therapy and systemic rituximab on the outcome of diffuse large B-cell lymphoma at risk of central nervous system disease is controversial. Furthermore, the effect of intrathecal treatment and rituximab in diffuse large B-cell and Burkitt lymphoma with occult leptomeningeal disease detected by flow cytometry at diagnosis is unknown. Untreated diffuse large B-cell (n=246) and Burkitt (n=80) lymphoma at clinical risk of central nervous system disease and having had pre-treatment cerebrospinal fluid were analyzed by flow cytometry and cytology. Spinal fluid involvement was detected by flow cytometry alone (occult) in 33 (13%) diffuse large B-cell and 9 (11%) Burkitt lymphoma patients, and detected by cytology in 11 (4.5%) and 5 (6%) patients, respectively. Diffuse large B-cell lymphoma with occult spinal fluid involvement had poorer survival (P=0.0001) and freedom from central nervous system relapse (P
