Final results of a multicenter trial addressing role of CSF flow cytometric analysis in NHL patients at high risk for CNS dissemination

Giulia Benevolo, Alessandra Stacchini, Michele Spina, Andrés J M Ferreri, Marcella Arras, Laura Bellio, Barbara Botto, Pietro Bulian, Maria Cantonetti, Lorella Depaoli, Nicola Di Renzo, Alice Di Rocco, Andrea Evangelista, Silvia Franceschetti, Laura Godio, Francesco Mannelli, Vincenzo Pavone, Pietro Pioltelli, Umberto Vitolo, Enrico M. Pogliani

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Abstract

This prospective study compared diagnostic and prognostic value of conventional cytologic (CC) examination and flow cytometry (FCM) of baseline samples of cerebrospinal fluid (CSF) in 174 patients with newly diagnosed aggressive non-Hodgkin lymphoma (NHL). FCM detected a neoplastic population in the CSF of 18 of 174 patients (10%), CC only in 7 (4%; P +/CC-). At a median follow-up of 46 months, there were 64 systemic progressions and 10 CNS relapses, including 2 patients with both systemic and CNS relapses. Two-year progression-free and overall survival were significantly higher in patients with FCM- CSF (62% and 72%) compared with those FCM+ CSF (39% and 50%, respectively), with a 2-year CNS relapse cumulative incidence of 3% (95% confidence interval [CI], 0-7) versus 17% (95% CI, 0-34; P =.004), respectively. The risk of CNS progression was significantly higher in FMC+/CC - versus FCM-/CC- patients (hazard ratio = 8.16, 95% CI, 1.45-46). In conclusion, FCM positivity in the CSF of patients with high-risk NHL is associated with a significantly higher CNS relapse risk and poorer outcome. The combination of IV drugs with a higher CNS bioavailability and intrathecal chemotherapy is advisable to prevent CNS relapses in FCM+ patients.

Original languageEnglish
Pages (from-to)3222-3228
Number of pages7
JournalBlood
Volume120
Issue number16
DOIs
Publication statusPublished - Oct 18 2012

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Cerebrospinal fluid
Flow cytometry
Non-Hodgkin's Lymphoma
Multicenter Studies
Cerebrospinal Fluid
Flow of fluids
Flow Cytometry
Recurrence
Confidence Intervals
Chemotherapy
Drug Combinations
Biological Availability
Disease-Free Survival
Hazards
Prospective Studies
Drug Therapy
Incidence
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Hematology
  • Biochemistry
  • Cell Biology
  • Immunology

Cite this

Final results of a multicenter trial addressing role of CSF flow cytometric analysis in NHL patients at high risk for CNS dissemination. / Benevolo, Giulia; Stacchini, Alessandra; Spina, Michele; Ferreri, Andrés J M; Arras, Marcella; Bellio, Laura; Botto, Barbara; Bulian, Pietro; Cantonetti, Maria; Depaoli, Lorella; Di Renzo, Nicola; Di Rocco, Alice; Evangelista, Andrea; Franceschetti, Silvia; Godio, Laura; Mannelli, Francesco; Pavone, Vincenzo; Pioltelli, Pietro; Vitolo, Umberto; Pogliani, Enrico M.

In: Blood, Vol. 120, No. 16, 18.10.2012, p. 3222-3228.

Research output: Contribution to journalArticle

Benevolo, G, Stacchini, A, Spina, M, Ferreri, AJM, Arras, M, Bellio, L, Botto, B, Bulian, P, Cantonetti, M, Depaoli, L, Di Renzo, N, Di Rocco, A, Evangelista, A, Franceschetti, S, Godio, L, Mannelli, F, Pavone, V, Pioltelli, P, Vitolo, U & Pogliani, EM 2012, 'Final results of a multicenter trial addressing role of CSF flow cytometric analysis in NHL patients at high risk for CNS dissemination', Blood, vol. 120, no. 16, pp. 3222-3228. https://doi.org/10.1182/blood-2012-04-423095
Benevolo, Giulia ; Stacchini, Alessandra ; Spina, Michele ; Ferreri, Andrés J M ; Arras, Marcella ; Bellio, Laura ; Botto, Barbara ; Bulian, Pietro ; Cantonetti, Maria ; Depaoli, Lorella ; Di Renzo, Nicola ; Di Rocco, Alice ; Evangelista, Andrea ; Franceschetti, Silvia ; Godio, Laura ; Mannelli, Francesco ; Pavone, Vincenzo ; Pioltelli, Pietro ; Vitolo, Umberto ; Pogliani, Enrico M. / Final results of a multicenter trial addressing role of CSF flow cytometric analysis in NHL patients at high risk for CNS dissemination. In: Blood. 2012 ; Vol. 120, No. 16. pp. 3222-3228.
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abstract = "This prospective study compared diagnostic and prognostic value of conventional cytologic (CC) examination and flow cytometry (FCM) of baseline samples of cerebrospinal fluid (CSF) in 174 patients with newly diagnosed aggressive non-Hodgkin lymphoma (NHL). FCM detected a neoplastic population in the CSF of 18 of 174 patients (10{\%}), CC only in 7 (4{\%}; P +/CC-). At a median follow-up of 46 months, there were 64 systemic progressions and 10 CNS relapses, including 2 patients with both systemic and CNS relapses. Two-year progression-free and overall survival were significantly higher in patients with FCM- CSF (62{\%} and 72{\%}) compared with those FCM+ CSF (39{\%} and 50{\%}, respectively), with a 2-year CNS relapse cumulative incidence of 3{\%} (95{\%} confidence interval [CI], 0-7) versus 17{\%} (95{\%} CI, 0-34; P =.004), respectively. The risk of CNS progression was significantly higher in FMC+/CC - versus FCM-/CC- patients (hazard ratio = 8.16, 95{\%} CI, 1.45-46). In conclusion, FCM positivity in the CSF of patients with high-risk NHL is associated with a significantly higher CNS relapse risk and poorer outcome. The combination of IV drugs with a higher CNS bioavailability and intrathecal chemotherapy is advisable to prevent CNS relapses in FCM+ patients.",
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AU - Benevolo, Giulia

AU - Stacchini, Alessandra

AU - Spina, Michele

AU - Ferreri, Andrés J M

AU - Arras, Marcella

AU - Bellio, Laura

AU - Botto, Barbara

AU - Bulian, Pietro

AU - Cantonetti, Maria

AU - Depaoli, Lorella

AU - Di Renzo, Nicola

AU - Di Rocco, Alice

AU - Evangelista, Andrea

AU - Franceschetti, Silvia

AU - Godio, Laura

AU - Mannelli, Francesco

AU - Pavone, Vincenzo

AU - Pioltelli, Pietro

AU - Vitolo, Umberto

AU - Pogliani, Enrico M.

PY - 2012/10/18

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N2 - This prospective study compared diagnostic and prognostic value of conventional cytologic (CC) examination and flow cytometry (FCM) of baseline samples of cerebrospinal fluid (CSF) in 174 patients with newly diagnosed aggressive non-Hodgkin lymphoma (NHL). FCM detected a neoplastic population in the CSF of 18 of 174 patients (10%), CC only in 7 (4%; P +/CC-). At a median follow-up of 46 months, there were 64 systemic progressions and 10 CNS relapses, including 2 patients with both systemic and CNS relapses. Two-year progression-free and overall survival were significantly higher in patients with FCM- CSF (62% and 72%) compared with those FCM+ CSF (39% and 50%, respectively), with a 2-year CNS relapse cumulative incidence of 3% (95% confidence interval [CI], 0-7) versus 17% (95% CI, 0-34; P =.004), respectively. The risk of CNS progression was significantly higher in FMC+/CC - versus FCM-/CC- patients (hazard ratio = 8.16, 95% CI, 1.45-46). In conclusion, FCM positivity in the CSF of patients with high-risk NHL is associated with a significantly higher CNS relapse risk and poorer outcome. The combination of IV drugs with a higher CNS bioavailability and intrathecal chemotherapy is advisable to prevent CNS relapses in FCM+ patients.

AB - This prospective study compared diagnostic and prognostic value of conventional cytologic (CC) examination and flow cytometry (FCM) of baseline samples of cerebrospinal fluid (CSF) in 174 patients with newly diagnosed aggressive non-Hodgkin lymphoma (NHL). FCM detected a neoplastic population in the CSF of 18 of 174 patients (10%), CC only in 7 (4%; P +/CC-). At a median follow-up of 46 months, there were 64 systemic progressions and 10 CNS relapses, including 2 patients with both systemic and CNS relapses. Two-year progression-free and overall survival were significantly higher in patients with FCM- CSF (62% and 72%) compared with those FCM+ CSF (39% and 50%, respectively), with a 2-year CNS relapse cumulative incidence of 3% (95% confidence interval [CI], 0-7) versus 17% (95% CI, 0-34; P =.004), respectively. The risk of CNS progression was significantly higher in FMC+/CC - versus FCM-/CC- patients (hazard ratio = 8.16, 95% CI, 1.45-46). In conclusion, FCM positivity in the CSF of patients with high-risk NHL is associated with a significantly higher CNS relapse risk and poorer outcome. The combination of IV drugs with a higher CNS bioavailability and intrathecal chemotherapy is advisable to prevent CNS relapses in FCM+ patients.

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