title: Clinical features and treatment outcomes of isolated secondary central nervous system lymphomas in Miyazaki Prefecture.
abstract: BACKGROUND
  Secondary central nervous system lymphoma (SCNSL) without extra-central nervous system (CNS) involvement is characterized by isolated secondary CNS relapse in malignant lymphoma patients. SCNSL is a rare disease, and no standard treatment has yet been established.
  
  
  METHODS
  To elucidate the clinical characteristics and outcomes of SCNSL, we retrospectively analyzed 12 patients (median age 67 years) in Miyazaki prefecture for the last 5 years.
  
  
  RESULTS
  The initial histological diagnoses of the patients were diffuse large B-cell lymphoma (DLBCL), mantle-cell lymphoma, and adult T-cell lymphoma in 9, 2, and 1 patient, respectively. We focused on analysis of the 9 SCNSL cases originating from DLBCL. The locations of CNS relapse were the cerebral hemisphere, basal ganglia, and cerebellum in 7, 1, and 1 patient, respectively. Three patients were treated with high-dose methotrexate (HD-MTX) therapy; 4 with whole-brain radiation therapy (WBRTX); and 1 with both HD-MTX and WBRTX. The remaining patients were treated with rituximab. Partial remission was achieved in 6 out of 9 patients (67%); the other 3 patients (33%) did not respond to therapy. Median survival of the 9 patients with CNS relapse was 253 days; 6 of the 9 patients survived for more than 6 months. As of March 2011, 2 HD-MTX group patients but none of the WBRTX group patients were alive.
  
  
  CONCLUSIONS
  In this retrospective study, 6 of 9 patients with SCNSL originating from DLBCL survived for more than 6 months. Both HD-MTX and WBRTX had clinical benefits in the treatment of SCNSL.
authors: Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan. kawanoriaki@yahoo.co.jp
authors: Noriaki
authors: N
authors: Kawano
authors: Hidenobu
authors: H
authors: Ochiai
authors: Shuro
authors: S
authors: Yoshida
authors: Kiyoshi
authors: K
authors: Yamashita
authors: Kotaro
authors: K
authors: Shide
authors: Haruko
authors: H
authors: Shimoda
authors: Tomonori
authors: T
authors: Hidaka
authors: Yoko
authors: Y
authors: Kubuki
authors: Keiko
authors: K
authors: Katayose
authors: Takanori
authors: T
authors: Toyama
authors: Hiroshi
authors: H
authors: Kawano
authors: Hitoshi
authors: H
authors: Matsuoka
authors: Junzo
authors: J
authors: Ishizaki
authors: Koichi
authors: K
authors: Maeda
authors: Seiichi
authors: S
authors: Satou
authors: Tatsuhiko
authors: T
authors: Yano
authors: Kenichiro
authors: K
authors: Yamaguchi
authors: Katsuto
authors: K
authors: Takenaka
authors: Yoshiya
authors: Y
authors: Shimao
authors: Koichi
authors: K
authors: Oshima
authors: Akira
authors: A
authors: Ueda
authors: Kazuya
authors: K
authors: Shimoda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D016543:Central Nervous System Neoplasms / Q000134:cerebrospinal fluid / Q000473:pathology / Q000556:secondary; D005260:Female; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000134:cerebrospinal fluid / Q000473:pathology / Q000628:therapy; D016399:Lymphoma, T-Cell / Q000134:cerebrospinal fluid / Q000473:pathology / Q000628:therapy; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D000069283:Rituximab; D016896:Treatment Outcome
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D008727:Methotrexate