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Blood, 1 February 2008, Vol. 111, No. 3, pp. 1085-1093. Prepublished online as a Blood First Edition Paper on October 25, 2007; DOI 10.1182/blood-2007-07-101402. This Article Full Text Full Text (PDF) Supplemental Appendix All Versions of this Article: blood-2007-07-101402v1 111/3/1085    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Doolittle, N. D. Articles by Zucca, E. Search for Related Content PubMed PubMed Citation Articles by Doolittle, N. D. Articles by Zucca, E. Related Collections Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Brain parenchyma involvement as isolated central nervous system relapse of systemic non-Hodgkin lymphoma: an International Primary CNS Lymphoma Collaborative Group report Nancy D. Doolittle1, Lauren E. Abrey2, Tamara N. Shenkier3, Siegal Tali4, Jacoline E.C. Bromberg5, Edward A. Neuwelt1,6, Carole Soussain7, Kristoph Jahnke8, Patrick Johnston9, Gerald Illerhaus10, David Schiff11, Tracy Batchelor12, Silvia Montoto13, Dale F. Kraemer14, and Emanuele Zucca15 1 Department of Neurology, Oregon Health and Science University, Portland; 2 Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY; 3 Division of Medical Oncology, British Columbia Cancer Agency and University of British Columbia, Vancouver; 4 Leslie and Michael Gaffin Center for Neuro-Oncology, Hadassah Hebrew University Hospital, Jerusalem, Israel; 5 Department of Neuro-Oncology, Daniel den Hoed Cancer Center, Erasmus MC University Medical Center, Rotterdam, the Netherlands; 6 Department of Neurosurgery, Oregon Health and Science University, and Portland Veterans Affairs Medical Center, Portland; 7 Department of Hematology, Centre Rene Huguenin, Saint Cloud, France; 8 Department of Hematology, Oncology, and Transfusion Medicine, Charité University Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany; 9 Divisions of Hematology and Blood and Marrow Transplant, Mayo Clinic College of Medicine, Rochester, MN; 10 Department of Hematology and Oncology, University Medical Center, Freiburg, Germany; 11 University of Virginia Neuro-Oncology Center, Charlottesville; 12 Stephen E. and Catherine Pappas Center for Neuro-Oncology, Massachusetts General Hospital, Boston; 13 Cancer Research United Kingdom–Medical Oncology Unit, Barts and the London, London, United Kingdom; 14 Department of Pharmacy Practice, Oregon State University, Portland; and 15 Medical Oncology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland 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 front-line 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. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: L. Angelov, N. D. Doolittle, D. F. Kraemer, T. Siegal, G. H. Barnett, D. M. Peereboom, G. Stevens, J. McGregor, K. Jahnke, C. A. Lacy, et al. Blood-Brain Barrier Disruption and Intra-Arterial Methotrexate-Based Therapy for Newly Diagnosed Primary CNS Lymphoma: A Multi-Institutional Experience J. Clin. Oncol., July 20, 2009; 27(21): 3503 - 3509. [Abstract] [Full Text] [PDF] CNS Relapse in Non-Hodgkin Lymphoma Journal Watch Oncology and Hematology, February 19, 2008; 2008(219): 4 - 4. 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