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Risk Factors of Central Nervous System Relapse In Mantle Cell Lymphoma.
MedLine Citation:
PMID:  23339449     Owner:  NLM     Status:  Publisher    
ABSTRACT Central nervous system (CNS) relapse has not been extensively studied in mantle cell lymphoma (MCL). We retrospectively analysed the risk factors and pattern of CNS relapse in consecutive MCL patients. We identified 142 cases of MCL treated from 1980 to 2011. Median age at diagnosis was 68 years; 82% of patients had advanced stage; extranodal disease was reported in 89% of cases, high serum lactate dehydrogenase (LDH) in 40%. Fourteen patients (10%) did not receive treatment at diagnosis. Chemotherapy was administered to 125 patients (88%), in 21 cases (15%) including drugs penetrating into the CNS or given intrathecally, 49 patients (35%) had rituximab. Ten patients had front-line autologous transplantation. After median follow-up of 7.9 years, CNS relapse occurred in 11 cases (7.8%) at a median of 13.8 months. Actuarial risk of CNS relapse was higher in patients with elevated LDH (P=0.002), higher International Prognostic Index (IPI) scores (P=0.018) and blastoid histology (P<0.0001). Blastoid histology retained significance at multivariate analysis. Median survival after CNS relapse was 6.3 months. No front-line treatment reduced the risk of CNS relapse. Our analysis confirm the poor outcome of MCL after CNS relapse and may allow the identification of patients needing prophylaxis of CNS relapse.
A Conconi; S Franceschetti; C Lobetti-Bodoni; A Stathis; G Margiotta Casaluci; A Ramponi; L Mazzucchelli; F Bertoni; M Ghielmini; G Gaidano; F Cavalli; E Zucca
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-23
Journal Detail:
Title:  Leukemia & lymphoma     Volume:  -     ISSN:  1029-2403     ISO Abbreviation:  Leuk. Lymphoma     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9007422     Medline TA:  Leuk Lymphoma     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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