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Final results of a multicenter trial addressing role of CSF flow cytometric analysis in NHL patients at high risk for CNS dissemination.
- Source :
-
Blood [Blood] 2012 Oct 18; Vol. 120 (16), pp. 3222-8. Date of Electronic Publication: 2012 Aug 27. - Publication Year :
- 2012
-
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 < .001); 11 patients (14%) were discordant (FCM(+)/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.
- Subjects :
- Adult
Combined Modality Therapy
Cytodiagnosis
Female
Humans
Immunophenotyping
Incidence
Italy epidemiology
Lymphoma, Non-Hodgkin pathology
Lymphoma, Non-Hodgkin therapy
Male
Meningeal Neoplasms secondary
Meningeal Neoplasms therapy
Middle Aged
Neoplasm Recurrence, Local cerebrospinal fluid
Neoplasm Recurrence, Local pathology
Neoplasm Staging
Prognosis
Prospective Studies
Risk Factors
Flow Cytometry
Lymphoma, Non-Hodgkin cerebrospinal fluid
Meningeal Neoplasms cerebrospinal fluid
Neoplasm Recurrence, Local epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1528-0020
- Volume :
- 120
- Issue :
- 16
- Database :
- MEDLINE
- Journal :
- Blood
- Publication Type :
- Academic Journal
- Accession number :
- 22927246
- Full Text :
- https://doi.org/10.1182/blood-2012-04-423095