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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 (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 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. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted July 16, 2007 Accepted October 22, 2007 Brain parenchyma involvement as isolated central nervous system (CNS) 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 EC Bromberg, Edward A Neuwelt, Carole Soussain, Kristoph Jahnke, Patrick Johnston, Gerald Illerhaus, David Schiff, Tracy Batchelor, Silvia Montoto, Dale F Kraemer, and Emanuele Zucca Department of Neurology, Oregon Health & Science University, Portland, OR, United States Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY, United States Division of Medical Oncology, British Columbia Cancer Agency and University of British Columbia, Vancouver, Canada Leslie and Michael Gaffin Center for Neuro-Oncology, Hadassah Hebrew University Hospital, Jerusalem, Israel Department of Neuro-Oncology, Daniel den Hoed Cancer Center, ErasmusMC University Medical Center, Rotterdam, Netherlands Department of Neurosurgery, Oregon Health & Science University, Portland, OR, United States Department of Hematology, Centre Rene Huguenin, Saint Cloud, France Department of Hematology, Oncology and Transfusion Medicine, Charite University Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany Divisions of Hematology and Blood and Marrow Transplant, Mayo Clinic College of Medicine, Rochester, MN, United States Department of Hematology and Oncology, University Medical Center, Freiburg, Freiburg, Germany Neuro-Oncology Center, University of Virginia, Charlottesville, VA, United States Stephen E. and Catherine Pappas Center for Neuro-Oncology, Massachusetts General Hospital, Boston, MA, United States Cancer Research United Kingdom - Medical Oncology Unit, Barts and the London, London, United Kingdom Department of Pharmacy Practice, Oregon State University, Portland, OR, United States Medical Oncology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland * Corresponding author; email: doolittl{at}ohsu.edu. 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. Following 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. Ninety-four (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% CI: 0.9-2.6 years); 26 (23%) have survived 3 years or more. Median time to progression was 1.0 year (95% CI: 0.7-1.7 years). Age less than 60 years (P = 0.0055) at relapse and methotrexate use (P = 0.0076) as front-line treatment for brain relapse, are 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: CNS Relapse in Non-Hodgkin Lymphoma Journal Watch Oncology and Hematology, February 19, 2008; 2008(219): 4 - 4. [Full Text]

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