title: Elevated LDH and paranasal sinus involvement are risk factors for central nervous system involvement in patients with peripheral T-cell lymphoma.
abstract: BACKGROUND
  The incidence and risk factors of central nervous system (CNS) involvement in peripheral T-cell lymphomas (PTCLs) are still unclear.
  
  
  METHODS
  We analyzed 228 patients with PTCLs, excluding cases of extranodal natural killer/T-cell lymphoma and primary cutaneous T-cell lymphoma, by retrospectively collecting the clinical features and outcomes of the patients.
  
  
  RESULTS
  Twenty events (8.77%, 20/228) of CNS involvement were observed during a median follow-up period of 13.9 months (range 0.03-159.43). Based on univariate analysis, elevated serum lactate dehydrogenase (LDH) level [P = 0.019, relative risk (RR) 5.904, 95% confidence interval (CI) 1.334-26.123] and involvement of the paranasal sinus (P = 0.032, RR 3.137, 95% CI 1.105-8.908) adversely affect CNS involvement. In multivariate analysis, both were independently poor prognostic factors for CNS relapse [elevated LDH level: P = 0.011, hazard ratio (HR) 6.716, 95% CI 1.548-29.131; involvement of the paranasal sinus: P = 0.008, HR 3.784, 95% CI 1.420-10.083]. The survival duration of patients with CNS involvement was significantly shorter than that of the patients without CNS involvement (P = 0.009), with median overall survival of 7.60 months (95% CI of 4.92-10.28) versus 27.43 months (95% CI of 0.00-57.38), respectively.
  
  
  CONCLUSIONS
  Elevated LDH level and involvement of the paranasal sinus are two risk factors for CNS involvement in patients with PTCLs. Considering the poor prognoses after CNS relapse, prophylaxis should be considered with the presence of any risk factor.
authors.affiliation: Division of Hematology-Oncology, Department of Medicine.
authors.forename: J H
authors.initials: JH
authors.lastname: Yi
authors.affiliation: Division of Hematology-Oncology, Department of Medicine.
authors.forename: J H
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Division of Hematology-Oncology, Department of Medicine.
authors.forename: K K
authors.initials: KK
authors.lastname: Baek
authors.affiliation: Division of Hematology-Oncology, Department of Medicine.
authors.forename: T
authors.initials: T
authors.lastname: Lim
authors.affiliation: Division of Hematology-Oncology, Department of Medicine.
authors.forename: D J
authors.initials: DJ
authors.lastname: Lee
authors.affiliation: Department of Radiation Oncology.
authors.forename: Y C
authors.initials: YC
authors.lastname: Ahn
authors.affiliation: Division of Hematology-Oncology, Department of Medicine.
authors.forename: K
authors.initials: K
authors.lastname: Kim
authors.affiliation: Division of Hematology-Oncology, Department of Medicine.
authors.forename: S J
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Y H
authors.initials: YH
authors.lastname: Ko
authors.affiliation: Division of Hematology-Oncology, Department of Medicine. Electronic address: wskimsmc@skku.edu.
authors.forename: W S
authors.initials: WS
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016543:Central Nervous System Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood*; D016411:Lymphoma, T-Cell, Peripheral / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D010255:Paranasal Sinus Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology; D011241:Prednisone / Q000627:therapeutic use; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome; D014750:Vincristine / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D007770:L-Lactate Dehydrogenase; D011241:Prednisone