Central nervous system involvement in mantle cell lymphoma: Clinical features, prognostic factors and outcomes from the European mantle cell lymphoma network

C. Y. Cheah, A. George, E. Giné, A. Chiappella, H. C. Kluin-Nelemans, W. Jurczak, K. Krawczyk, H. Mocikova, P. Klener, D. Salek, J. Walewski, M. Szymczyk, L. Smolej, R. L. Auer, D. S. Ritchie, L. Arcaini, M. E. Williams, M. Dreyling, J. F. Seymour

Research output: Contribution to journalArticle

Abstract

Background: Central nervous system (CNS) involvement in mantle cell lymphoma (MCL) is uncommon, and the manifestations and natural history are not well described. Patients and methods: We present the data on 57 patients with MCL who developed CNS involvement, from a database of 1396 consecutively treated patients at 14 institutions. Results: The crude incidence of CNS involvement was 4.1%, with 0.9% having CNS involvement at diagnosis. Blastoid histology, B-symptoms, elevated lactate dehydrogenase, Eastern Cooperative Group performance status ≥2 and a high Mantle Cell Lymphoma International Prognostic Index score were enriched in the cohort with CNS involvement, and the presence of ≥1 of these features defined a high-risk subset (an actuarial risk of CNS involvement 15% at 5 years) in a single-institution subset. The median time to CNS relapse was 15.2 months, and the median survival from time of CNS diagnosis was 3.7 months. The white blood cell count at diagnosis >10.9 × 109/l, treatment of CNS involvement with high-dose anti-metabolites, consolidation with stem cell transplant and achievement of complete response were all associated with improved survival. Conclusions: In MCL, CNS involvement is uncommon, although some features may predict risk. Once manifest outlook is poor; however, some patients who receive intensive therapy survive longer than 12 months.

Original languageEnglish
Pages (from-to)2119-2123
Number of pages5
JournalAnnals of Oncology
Volume24
Issue number8
DOIs
Publication statusPublished - Aug 2013

Keywords

  • Central nervous system
  • Mantle cell lymphoma
  • Prognosis

ASJC Scopus subject areas

  • Oncology
  • Hematology

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    Cheah, C. Y., George, A., Giné, E., Chiappella, A., Kluin-Nelemans, H. C., Jurczak, W., Krawczyk, K., Mocikova, H., Klener, P., Salek, D., Walewski, J., Szymczyk, M., Smolej, L., Auer, R. L., Ritchie, D. S., Arcaini, L., Williams, M. E., Dreyling, M., & Seymour, J. F. (2013). Central nervous system involvement in mantle cell lymphoma: Clinical features, prognostic factors and outcomes from the European mantle cell lymphoma network. Annals of Oncology, 24(8), 2119-2123. https://doi.org/10.1093/annonc/mdt139