Retrospective study of prognostic factors in non-Hodgkin lymphoma secondarily involving the central nervous system.
The aim of this retrospective single-center study was to analyze the clinical characteristics and outcome of non-Hodgkin lymphoma (NHL) patients with central nervous system (CNS) involvement and to identify prognostic factors for survival. We searched our hospital records for NHL patients diagnosed with CNS involvement from 1982 to 2004, and 43 patients were identified. The median age was 63 years (range 23-88) and the median Karnofsky performance status was 55% (range 10-90). Treatment of CNS lymphoma included intrathecal chemotherapy in 33 patients (77%), systemic chemotherapy in 25 (58%), and radiotherapy in 16 (37%). Twenty-six patients showed a CNS response. The median survival after CNS manifestation was 5 months (range 2 days-82.5+months). Nine patients achieved long-term survival. Low lactate dehydrogenase (LDH) at CNS manifestation and a CNS response to therapy were favorable independent prognostic factors for survival in multivariate analysis (p = 0.051 and p < 0.0005, respectively), whereas a young age at initial diagnosis, initial CNS involvement, an initially normal LDH, and high-dose chemotherapy for CNS involvement were significant in univariate analysis. In conclusion, long-term survival can be achieved in patients with secondary CNS lymphoma. LDH at CNS manifestation and a CNS response to therapy were significantly associated with survival.
Jahnke
Kristoph
K
Department of Hematology, Oncology and Transfusion Medicine, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200 Berlin, Germany. kristoph.jahnke@charite.de
Thiel
Eckhard
E
Martus
Peter
P
Schwartz
Stefan
S
Korfel
Agnieszka
A
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016543:Central Nervous System Neoplasms / Q000201:enzymology / Q000401:mortality* / Q000556:secondary / Q000628:therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000378:metabolism; D008228:Lymphoma, Non-Hodgkin / Q000201:enzymology / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies
D007770:L-Lactate Dehydrogenase