title: Multimodal therapy for localized spinal epidural follicular lymphoma.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Division of Hematology and Oncology, University of Rostock, Germany. christoph.kahl@med.uni-rostock.de
authors.forename: Christoph
authors.initials: C
authors.lastname: Kahl
authors.forename: Carsten
authors.initials: C
authors.lastname: Hirt
authors.forename: Susanne
authors.initials: S
authors.lastname: Decker
authors.forename: Dietrich
authors.initials: D
authors.lastname: Gläser
authors.forename: Sebastian
authors.initials: S
authors.lastname: Rohde
authors.forename: Kirsten
authors.initials: K
authors.lastname: Jost
authors.forename: Inken
authors.initials: I
authors.lastname: Hilgendorf
authors.forename: Eva
authors.initials: E
authors.lastname: Respondek-Dryba
authors.forename: Malte
authors.initials: M
authors.lastname: Leithäuser
authors.forename: Christian
authors.initials: C
authors.lastname: Junghanss
authors.forename: Mathias
authors.initials: M
authors.lastname: Freund
mesh_terms: 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