title: Prognostic impact of meningeal dissemination in primary CNS lymphoma (PCNSL): experience from the G-PCNSL-SG1 trial.
abstract: BACKGROUND
  We evaluated the frequency and prognostic impact of meningeal dissemination (MD) in immunocompetent adult patients with primary central nervous system lymphoma treated in a randomized phase III trial.
  
  
  METHODS
  MD was evaluated at study entry and defined by lymphoma proof in the meningeal compartment detected by at least one of the following methods: cerebrospinal fluid (CSF) cytomorphology, detection of clonal B cells by IgH PCR in CSF or contrast enhancement of the leptomeninges on magnetic resonance imaging (MRI).
  
  
  RESULTS
  Data on MD were available in 415 patients, of those, MD was detected in 65 (15.7%): in 44/361 (12.2%) by CSF cytomorphology, in 16/152 (10.5%) by PCR and in 17/415 (4.1%) by MRI. Major patients' characteristics and therapy did not significantly differ between patients with MD (MD+) versus those without MD (MD-). There was a significant correlation of MD with CSF pleocytosis (>5/μl; P < 0.0001), but no correlation with CSF protein elevation (>45 mg/dl). Median progression-free survival was 6.7 months [95% confidence interval (CI) 0-14.5] in MD+ and 8.3 months (5.7-10.8) in MD- patients (P = 0.95); median overall survival was 21.5 months (95% CI 16.8-26.1) and 24.9 months (17.5-32.3), respectively (P = 0.98).
  
  
  CONCLUSIONS
  MD was detected infrequently and had no impact on outcome in this trial.
authors.affiliation: Department of Hematology & Oncology, Campus Benjamin Franklin, Charite Berlin, Berlin, Germany. Electronic address: agnieszka.korfel@charite.de.
authors.forename: A
authors.initials: A
authors.lastname: Korfel
authors.affiliation: Department of Neurology, University Hospital Zurich, Zurich, Switzerland; Department of Neurology, University Hospital Tuebingen, Tuebingen.
authors.forename: M
authors.initials: M
authors.lastname: Weller
authors.affiliation: Institute of Biostatistics, University Tuebingen, Tuebingen; Institute of Biostatistics, University Hospital Tuebingen, Tuebingen.
authors.forename: P
authors.initials: P
authors.lastname: Martus
authors.affiliation: Department of Neurology, University Hospital Zurich, Zurich, Switzerland; Department of Neurology, University Hospital Tuebingen, Tuebingen.
authors.forename: P
authors.initials: P
authors.lastname: Roth
authors.affiliation: Department of Hematology & Oncology, Pius Hospital, Oldenburg.
authors.forename: H A
authors.initials: HA
authors.lastname: Klasen
authors.affiliation: Department of Hematology, West German Cancer Center, University Hospital Essen, Essen.
authors.forename: A
authors.initials: A
authors.lastname: Roeth
authors.affiliation: Department of Hematology & Oncology, Evangelisches Krankenhaus Bielefeld, Bielefeld.
authors.forename: M
authors.initials: M
authors.lastname: Rauch
authors.affiliation: Department of Hematology & Oncology, Klinikum Bremen Mitte, Bremen.
authors.forename: B
authors.initials: B
authors.lastname: Hertenstein
authors.affiliation: Department of Hematology & Oncology, University of Magdeburg, Magdeburg.
authors.forename: T
authors.initials: T
authors.lastname: Fischer
authors.affiliation: Department of Hematology & Oncology, University Hospital Mainz, Mainz, Germany; Department of Neurology, Cantonal Hospital, St Gallen, Switzerland.
authors.forename: T
authors.initials: T
authors.lastname: Hundsberger
authors.affiliation: Department of Hematology & Oncology, University Hospital Rostock, Rostock.
authors.forename: M
authors.initials: M
authors.lastname: Leithäuser
authors.affiliation: Department of Neurology, University Hospital Grosshadern, Munich.
authors.forename: T
authors.initials: T
authors.lastname: Birnbaum
authors.affiliation: Department of Hematology & Oncology, Hospital Trier, Trier.
authors.forename: H
authors.initials: H
authors.lastname: Kirchen
authors.affiliation: Department of Oncology & Hematology, Klinikum Stuttgart, Stuttgart.
authors.forename: H-G
authors.initials: HG
authors.lastname: Mergenthaler
authors.affiliation: Department of Neurology, Hospital Minden, Minden.
authors.forename: J
authors.initials: J
authors.lastname: Schubert
authors.affiliation: Department of Medicine A, University Hospital Muenster, Muenster.
authors.forename: W
authors.initials: W
authors.lastname: Berdel
authors.affiliation: Department of Hematology & Oncology, Hospital Nürnberg, Nürnberg.
authors.forename: J
authors.initials: J
authors.lastname: Birkmann
authors.affiliation: Department of Pathology, Campus Benjamin Franklin, Charite Berlin, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Hummel
authors.affiliation: Department of Hematology & Oncology, Campus Benjamin Franklin, Charite Berlin, Berlin, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Thiel
authors.affiliation: Department of Hematology & Oncology, Campus Benjamin Franklin, Charite Berlin, Berlin, Germany.
authors.forename: L
authors.initials: L
authors.lastname: Fischer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016543:Central Nervous System Neoplasms / Q000134:cerebrospinal fluid / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008223:Lymphoma; D008297:Male; D008577:Meningeal Neoplasms / Q000134:cerebrospinal fluid / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D008875:Middle Aged; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D055815:Young Adult