TY - JOUR

T1 - Meningeal involvement in non‐Hodgkin's lymphoma

T2 - Symptoms, incidence, risk factors and treatment

AU - Ersbøll, Jens

AU - Schultz, Henrik B.

AU - Thomsen, Birthe L. R.

AU - Keiding, Niels

AU - Nissen, Nis I.

PY - 1985/11

Y1 - 1985/11

N2 - Meningeal involvement (MI) by non‐Hodgkin's lymphoma (NHL) was seen in 38/602 patients (6.3%). In relation to histologic subtype the frequency of MI was: Follicular small cleaved and mixed cell 2/128 (1.6%), small lymphocytic and diffuse small cleaved cell 2/83 (2.4%), large cell and immunoblastic 13/295 (4.5%), small noncleaved cell 6/31 (19%), lymphoblastic 15/66 (23%). Risk factors that predict for MI were, besides histologic subtype, age under 40 yr, clinical stage IV, site of involvement (bone marrow, bone, skin gastrointestinal tract), and a poor response to initial therapy. In a Cox multivariate model encompassing the intermediate and high grade malignancy groups of the Working Formulation (WF), the 3 most important risk factors were histology, age, and stage. The estimated 1‐yr probability of MI for combinations of the 3 risk factors was: 3 risk factors (61 %), 2 risk factors (15–28%), 1 risk factor (4–8%), 0 risk factor (1.5%). At the diagnosis of MI, 84% of the patients had evidence of advanced systemic NHL, and the median survival after MI was 10 wk. CNS prophylaxis with whole‐brain irradiation and intrathecal chemotherapy can only be recommended in patients with 2 or 3 risk factors. Improvement of the systemic chemotherapy might be the most important factor for prevention of MI in NHL.

AB - Meningeal involvement (MI) by non‐Hodgkin's lymphoma (NHL) was seen in 38/602 patients (6.3%). In relation to histologic subtype the frequency of MI was: Follicular small cleaved and mixed cell 2/128 (1.6%), small lymphocytic and diffuse small cleaved cell 2/83 (2.4%), large cell and immunoblastic 13/295 (4.5%), small noncleaved cell 6/31 (19%), lymphoblastic 15/66 (23%). Risk factors that predict for MI were, besides histologic subtype, age under 40 yr, clinical stage IV, site of involvement (bone marrow, bone, skin gastrointestinal tract), and a poor response to initial therapy. In a Cox multivariate model encompassing the intermediate and high grade malignancy groups of the Working Formulation (WF), the 3 most important risk factors were histology, age, and stage. The estimated 1‐yr probability of MI for combinations of the 3 risk factors was: 3 risk factors (61 %), 2 risk factors (15–28%), 1 risk factor (4–8%), 0 risk factor (1.5%). At the diagnosis of MI, 84% of the patients had evidence of advanced systemic NHL, and the median survival after MI was 10 wk. CNS prophylaxis with whole‐brain irradiation and intrathecal chemotherapy can only be recommended in patients with 2 or 3 risk factors. Improvement of the systemic chemotherapy might be the most important factor for prevention of MI in NHL.

KW - CNS prophylaxis

KW - Cox multivariate analysis

KW - meningeal lymphoma

KW - non‐Hodgkin's lymphoma

UR - http://www.scopus.com/inward/record.url?scp=0022372154&partnerID=8YFLogxK

U2 - 10.1111/j.1600-0609.1985.tb02817.x

DO - 10.1111/j.1600-0609.1985.tb02817.x

M3 - Journal article

C2 - 4089528

AN - SCOPUS:0022372154

VL - 35

SP - 487

EP - 496

JO - Scandinavian Journal of Haematology

JF - Scandinavian Journal of Haematology

SN - 0036-553X

IS - 5

ER -