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

doi:10.3324/haematol.2013.101741

Haematologica (Jul 2014)

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

DOI: https://doi.org/10.3324/haematol.2013.101741
Journal volume & issue: Vol. 99, no. 7

Abstract

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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

Published in Haematologica

ISSN: 0390-6078 (Print); 1592-8721 (Online)
Publisher: Ferrata Storti Foundation
Country of publisher: Italy
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the blood and blood-forming organs
Website: http://www.haematologica.org

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