Multimodal therapy for localized spinal epidural follicular lymphoma.
BACKGROUND
Myelopathy due to epidural spinal cord compression is rare in patients with malignant lymphoma and most of these patients are diagnosed with high-grade lymphoma. An epidural growth of low-grade lymphoma is even more unusual. Due to this low incidence, therapeutic experience for this entity is limited.


METHODS
We report the outcome of 3 consecutive patients with primary spinal epidural follicular lymphoma (FL). Due to the clinical disorders of the patients and despite the localized disease, we used an intensive multimodal therapy concept consisting of spinal decompression, systemic (immuno)chemotherapy and local irradiation. All patients improved in their medical condition; 2 achieved a complete remission, 1 of these with long-term remission.


CONCLUSIONS
In contrast to the established irradiation therapy for early-stage FL, an intensive multimodal therapy concept should be initiated in patients with primary spinal epidural FL. With this approach, a fast improvement of the symptoms and long-term disease-free survival is possible.
Kahl
Christoph
C
Department of Internal Medicine, Division of Hematology and Oncology, University of Rostock, Germany. christoph.kahl@med.uni-rostock.de
Hirt
Carsten
C
Decker
Susanne
S
Gläser
Dietrich
D
Rohde
Sebastian
S
Jost
Kirsten
K
Hilgendorf
Inken
I
Respondek-Dryba
Eva
E
Leithäuser
Malte
M
Junghanss
Christian
C
Freund
Mathias
M
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D019299:Decompression, Surgical; D018572:Disease-Free Survival; D015174:Epidural Neoplasms / Q000401:mortality / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007796:Laminectomy; D008224:Lymphoma, Follicular / Q000401:mortality / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D018714:Radiotherapy, Adjuvant; D013117:Spinal Cord Compression / Q000628:therapy; D013904:Thoracic Vertebrae