Treatment and Prevention of Secondary CNS Lymphoma

S. Nagpal; M. J. Glantz; Lawrence Recht

doi:10.1055/s-0030-1255222

Seminars in Neurology, Table of Contents

Semin Neurol 2010; 30(3): 263-272
DOI: 10.1055/s-0030-1255222

Treatment and Prevention of Secondary CNS Lymphoma

S. Nagpal¹ , M. J. Glantz² , Lawrence Recht¹

¹Department of Neurology, Stanford University Medical School, Stanford, California
²Departments of Neurosurgery and Oncology, Pennsylvania State College of Medicine, Hershey, Pennsylvania

Abstract

ABSTRACT

Central nervous system (CNS) involvement in non-Hodgkin lymphoma is a serious, potentially preventable complication that can occur in 5 to 10% of patients. Its occurrence is directly correlated with pathologic aggressiveness and ranges from less than 3% in the indolent, less-aggressive histologies to as high as 50% in the very aggressive ones such as Burkitt lymphoma. Aggressive treatment once detected can improve neurologic outcome, but because it is often associated with contemporaneous systemic relapse, is rarely associated with long-term survival. Preventing its occurrence, therefore, remains an important goal of initial treatment. Despite there being some suggestive evidence that the addition of systemic rituximab and several intracerebrospinal fluid chemotherapy regimens may have decreased the incidence of CNS involvement, both optimal selection of those patients who should receive prophylaxis as well as the best prophylactic regimen remain active areas of investigation.

KEYWORDS

Secondary CNS lymphoma - non-Hodgkin lymphoma - cerebrospinal fluid - CNS prophylaxis

Full Text

References

REFERENCES

1 Horner MJRL, Krapcho M, Neyman N, et al SEER Cancer Statistics Review, 1975–2006. Bethesda, MD; National Cancer Institute 2009
2 Colocci N, Glantz M, Recht L. Prevention and treatment of central nervous system involvement by non-Hodgkin's lymphoma: a review of the literature. Semin Neurol. 2004; 24(4) 395-404
3 Haioun C, Besson C, Lepage E et al.. Incidence and risk factors of central nervous system relapse in histologically aggressive non-Hodgkin's lymphoma uniformly treated and receiving intrathecal central nervous system prophylaxis: a GELA study on 974 patients. Groupe d'Etudes des Lymphomes de l'Adulte. Ann Oncol. 2000; 11(6) 685-690
4 Hollender A, Kvaloy S, Nome O, Skovlund E, Lote K, Holte H. Central nervous system involvement following diagnosis of non-Hodgkin's lymphoma: a risk model. Ann Oncol. 2002; 13(7) 1099-1107
5 Tomita N, Kodama F, Sakai R et al.. Predictive factors for central nervous system involvement in non-Hodgkin's lymphoma: significance of very high serum LDH concentrations. Leuk Lymphoma. 2000; 38(3-4) 335-343
6 van Besien K, Ha C S, Murphy S et al.. Risk factors, treatment, and outcome of central nervous system recurrence in adults with intermediate-grade and immunoblastic lymphoma. Blood. 1998; 91(4) 1178-1184
7 Bernstein S H, Unger J M, Leblanc M, Friedberg J, Miller T P, Fisher R I. Natural history of CNS relapse in patients with aggressive non-Hodgkin's lymphoma: a 20-year follow-up analysis of SWOG 8516 — the Southwest Oncology Group. J Clin Oncol. 2009; 27(1) 114-119
8 Jaffe ESHN, Stein H, Vardiman JW Pathology and genetics of tumours of haematopoietic and lymphoid tissues. In: World Health Organization Classification of Tumours. Lyon, France; IARC Press 2001
9 Hiddemann W, Longo D L, Coiffier B et al.. Lymphoma classification—the gap between biology and clinical management is closing. Blood. 1996; 88(11) 4085-4089
10 Seki R, Ohshima K, Nagafuji K et al.. Rituximab in combination with CHOP chemotherapy for the treatment of diffuse large B cell lymphoma in Japan: a retrospective analysis of 1,057 cases from Kyushu Lymphoma Study Group. Int J Hematol. 2010; 91(2) 258-266
11 Boehme V, Schmitz N, Zeynalova S, Loeffler M, Pfreundschuh M. CNS events in elderly patients with aggressive lymphoma treated with modern chemotherapy (CHOP-14) with or without rituximab: an analysis of patients treated in the RICOVER-60 trial of the German High-Grade Non-Hodgkin Lymphoma Study Group (DSHNHL). Blood. 2009; 113(17) 3896-3902
12 Villa D, Connors J M, Shenkier T N et al.. Incidence and risk factors for central nervous system relapse in patients with diffuse large B-cell lymphoma: the impact of the addition of rituximab to CHOP chemotherapy. Ann Oncol. 2010; 21(5) 1046-1052
13 Lim H Y, Thiel E, Glantz M J. To protect and defend: central nervous system prophylaxis in patients with non-Hodgkin's lymphoma. Curr Opin Oncol. 2008; 20(5) 495-501
14 Recht L, Straus D J, Cirrincione C, Thaler H T, Posner J B. Central nervous system metastases from non-Hodgkin's lymphoma: treatment and prophylaxis. Am J Med. 1988; 84(3 Pt 1) 425-435
15 Hegde U, Filie A, Little R F et al.. High incidence of occult leptomeningeal disease detected by flow cytometry in newly diagnosed aggressive B-cell lymphomas at risk for central nervous system involvement: the role of flow cytometry versus cytology. Blood. 2005; 105(2) 496-502
16 Glantz M J, Cole B F, Glantz L K et al.. Cerebrospinal fluid cytology in patients with cancer: minimizing false-negative results. Cancer. 1998; 82(4) 733-739
17 Finn W G, Peterson L C, James C, Goolsby C L. Enhanced detection of malignant lymphoma in cerebrospinal fluid by multiparameter flow cytometry. Am J Clin Pathol. 1998; 110(3) 341-346
18 Bromberg J E, Breems D A, Kraan J et al.. CSF flow cytometry greatly improves diagnostic accuracy in CNS hematologic malignancies. Neurology. 2007; 68(20) 1674-1679
19 Brem S S, Bierman P J, Black P et al.. Central nervous system cancers. J Natl Compr Canc Netw. 2008; 6(5) 456-504
20 Zeiser R, Burger J A, Bley T A, Windfuhr-Blum M, Schulte-Mönting J, Behringer D M. Clinical follow-up indicates differential accuracy of magnetic resonance imaging and immunocytology of the cerebral spinal fluid for the diagnosis of neoplastic meningitis—a single centre experience. Br J Haematol. 2004; 124(6) 762-768
21 Strik H MPP, Pilgram-Pastor S, Buhk J H. Neoplastic meningitis—Is MRI as sensitive as CSF cytology?. Paper presented at: 2009 ASCO Annual Meeting May 29–June 2, 2009 Orlando, FL;
22 Su C S, Lan M Y, Chang Y Y, Lin W C, Liu K T. Clinical features, neuroimaging and treatment of spontaneous intracranial hypotension and magnetic resonance imaging evidence of blind epidural blood patch. Eur Neurol. 2009; 61(5) 301-307
23 Chamberlain M C, Glantz M, Groves M D, Wilson W H. Diagnostic tools for neoplastic meningitis: detecting disease, identifying patient risk, and determining benefit of treatment. Semin Oncol. 2009; 36(4, Suppl 2) S35-S45
24 Kara I O, Sahin B, Gunesacar R. Levels of serum and cerebrospinal fluid soluble CD27 in the diagnosis of leptomeningeal involvement of hematolymphoid malignancies. Adv Ther. 2007; 24(4) 741-747
25 Stockhammer G, Poewe W, Burgstaller S et al.. Vascular endothelial growth factor in CSF: a biological marker for carcinomatous meningitis. Neurology. 2000; 54(8) 1670-1676
26 Roy S, Josephson S A, Fridlyand J et al.. Protein biomarker identification in the CSF of patients with CNS lymphoma. J Clin Oncol. 2008; 26(1) 96-105
27 Zetterberg H, Andreasson U, Blennow K. CSF antithrombin III and disruption of the blood-brain barrier. J Clin Oncol. 2009; 27(13) 2302-2303, author reply 2303–2304
28 Glantz M J, Hall W A, Cole B F et al.. Diagnosis, management, and survival of patients with leptomeningeal cancer based on cerebrospinal fluid-flow status. Cancer. 1995; 75(12) 2919-2931
29 Brugières L, Le Deley M C, Rosolen A et al.. Impact of the methotrexate administration dose on the need for intrathecal treatment in children and adolescents with anaplastic large-cell lymphoma: results of a randomized trial of the EICNHL Group. J Clin Oncol. 2009; 27(6) 897-903
30 Grossman S A, Finkelstein D M, Ruckdeschel J C, Trump D L, Moynihan T, Ettinger D S. Eastern Cooperative Oncology Group . Randomized prospective comparison of intraventricular methotrexate and thiotepa in patients with previously untreated neoplastic meningitis. J Clin Oncol. 1993; 11(3) 561-569
31 Glantz M J, LaFollette S, Jaeckle K A et al.. Randomized trial of a slow-release versus a standard formulation of cytarabine for the intrathecal treatment of lymphomatous meningitis. J Clin Oncol. 1999; 17(10) 3110-3116
32 Glantz M J, Van Horn A, Fisher R, Chamberlain M C. Route of intracerebrospinal fluid chemotherapy administration and efficacy of therapy in neoplastic meningitis. Cancer. 2010; 116(8) 1947-1952
33 Liu C Y, Teng H W, Lirng J F, Chiou T J, Chen P M, Hsiao L T. Sustained remission and long-term survival of secondary central nervous system involvement by aggressive B-cell lymphoma after combination treatment of systemic high-dose chemotherapy and intrathecal rituximab. Leuk Lymphoma. 2008; 49(10) 2018-2021
34 Villela L, García M, Caballero R, Borbolla-Escoboza J R, Bolaños-Meade J. Rapid complete response using intrathecal rituximab in a patient with leptomeningeal lymphomatosis due to mantle cell lymphoma. Anticancer Drugs. 2008; 19(9) 917-920
35 Antonini G, Cox M C, Montefusco E et al.. Intrathecal anti-CD20 antibody: an effective and safe treatment for leptomeningeal lymphoma. J Neurooncol. 2007; 81(2) 197-199
36 Glantz M J, Jaeckle K A, Chamberlain M C et al.. A randomized controlled trial comparing intrathecal sustained-release cytarabine (DepoCyt) to intrathecal methotrexate in patients with neoplastic meningitis from solid tumors. Clin Cancer Res. 1999; 5(11) 3394-3402
37 Rubenstein J L, Fridlyand J, Abrey L et al.. Phase I study of intraventricular administration of rituximab in patients with recurrent CNS and intraocular lymphoma. J Clin Oncol. 2007; 25(11) 1350-1356
38 Pui C H, Thiel E. Central nervous system disease in hematologic malignancies: historical perspective and practical applications. Semin Oncol. 2009; 36(4, Suppl 2) S2-S16
39 Kikuchi A, Kawada H, Iwaki Y et al.. [Measurement of rituximab concentration in the cerebrospinal fluid in CNS lymphoma]. Rinsho Ketsueki. 2004; 45(12) 1255-1257
40 Harjunpää A, Wiklund T, Collan J et al.. Complement activation in circulation and central nervous system after rituximab (anti-CD20) treatment of B-cell lymphoma. Leuk Lymphoma. 2001; 42(4) 731-738
41 Arkenau H T, Chong G, Cunningham D et al.. The role of intrathecal chemotherapy prophylaxis in patients with diffuse large B-cell lymphoma. Ann Oncol. 2007; 18(3) 541-545
42 Boehme V, Zeynalova S, Kloess M German High-Grade Non-Hodgkin's Lymphoma Study Group (DSHNHL) et al. Incidence and risk factors of central nervous system recurrence in aggressive lymphoma—a survey of 1693 patients treated in protocols of the German High-Grade Non-Hodgkin's Lymphoma Study Group (DSHNHL). Ann Oncol. 2007; 18(1) 149-157
43 Goedert J J, Coté T R, Virgo P et al.. Spectrum of AIDS-associated malignant disorders. Lancet. 1998; 351(9119) 1833-1839
44 Opelz G, Döhler B. Lymphomas after solid organ transplantation: a collaborative transplant study report. Am J Transplant. 2004; 4(2) 222-230
45 Bihan C L, Chevojon P, Doll J et al.. Change in cause of death before and after introduction of highly active antiretroviral therapy (HAART): three general hospitals based study. Paper presented at: International Conference on AIDS July 7–12, 2002 Barcelona, Spain;
46 Tirelli U, Spina M, Vaccher E et al.. Clinical evaluation of 451 patients with HIV related non-Hodgkin's lymphoma: experience on the Italian cooperative group on AIDS and tumors (GICAT). Leuk Lymphoma. 1995; 20(1-2) 91-96
47 Schürmann D DD, Dienemann D, Jautzke G et al.. Malignant lymphomas in HIV-seropositive patients. Frequency, features, and prognosis. Report on 31 cases. Klin Wochenschr. 1991; 69(15) 679-686
48 Robotin M C, Law M G, Milliken S et al.. Clinical features and predictors of survival of AIDS-related non-Hodgkin's lymphoma in a population-based case series in Sydney, Australia. HIV Med. 2004; 5(5) 377-384
49 Diamond C, Taylor T H, Im T, Miradi M, Anton-Culver H. Improved survival and chemotherapy response among patients with AIDS-related non-Hodgkin's lymphoma receiving highly active antiretroviral therapy. Hematol Oncol. 2006; 24(3) 139-145
50 Palmieri C, Treibel T, Large O, Bower M. AIDS-related non-Hodgkin's lymphoma in the first decade of highly active antiretroviral therapy. QJM. 2006; 99(12) 811-826
51 Navarro J T, Vall-Llovera F, Mate J L, Morgades M, Feliu E, Ribera J M. Decrease in the frequency of meningeal involvement in AIDS-related systemic lymphoma in patients receiving HAART. Haematologica. 2008; 93(1) 149-150
52 Spina M, Chimienti E, Martellotta F et al.. Phase 2 study of intrathecal, long-acting liposomal cytarabine in the prophylaxis of lymphomatous meningitis in human immunodeficiency virus-related non-Hodgkin lymphoma. Cancer. 2010; 116(6) 1495-1501
53 Caillard S, Agodoa L Y, Bohen E M, Abbott K C. Myeloma, Hodgkin disease, and lymphoid leukemia after renal transplantation: characteristics, risk factors and prognosis. Transplantation. 2006; 81(6) 888-895
54 Buell J F, Gross T G, Hanaway M J et al.. Posttransplant lymphoproliferative disorder: significance of central nervous system involvement. Transplant Proc. 2005; 37(2) 954-955
55 Alvarnas J C, Negrin R S, Horning S J et al.. High-dose therapy with hematopoietic cell transplantation for patients with central nervous system involvement by non-Hodgkin's lymphoma. Biol Blood Marrow Transplant. 2000; 6(3A, 3A) 352-358
56 Bokstein F, Lossos A, Lossos I S, Siegal T. Central nervous system relapse of systemic non-Hodgkin's lymphoma: results of treatment based on high-dose methotrexate combination chemotherapy. Leuk Lymphoma. 2002; 43(3) 587-593
57 Kasamon Y L, Jones R J, Piantadosi S et al.. High-dose therapy and blood or marrow transplantation for non-Hodgkin lymphoma with central nervous system involvement. Biol Blood Marrow Transplant. 2005; 11(2) 93-100
58 Jahnke K, Thiel E, Martus P, Schwartz S, Korfel A. Retrospective study of prognostic factors in non-Hodgkin lymphoma secondarily involving the central nervous system. Ann Hematol. 2006; 85(1) 45-50
59 Matsumoto Y, Horiike S, Fujimoto Y et al.. Effectiveness and limitation of gamma knife radiosurgery for relapsed central nervous system lymphoma: a retrospective analysis in one institution. Int J Hematol. 2007; 85(4) 333-337
60 Garcia-Marco J A, Panizo C, Garcia E S et al.. Efficacy and safety of liposomal cytarabine in lymphoma patients with central nervous system involvement from lymphoma. Cancer. 2009; 115(9) 1892-1898
61 Chamberlain M C, Johnston S K, Van Horn A, Glantz M J. Recurrent lymphomatous meningitis treated with intra-CSF rituximab and liposomal ara-C. J Neurooncol. 2009; 91(3) 271-277
62 Fischer L, Korfel A, Kiewe P, Neumann M, Jahnke K, Thiel E. Systemic high-dose methotrexate plus ifosfamide is highly effective for central nervous system (CNS) involvement of lymphoma. Ann Hematol. 2009; 88(2) 133-139
63 Chua S L, Seymour J F, Streater J, Wolf M M, Januszewicz E H, Prince H M. Intrathecal chemotherapy alone is inadequate central nervous system prophylaxis in patients with intermediate-grade non-Hodgkin's lymphoma. Leuk Lymphoma. 2002; 43(9) 1783-1788
64 Tomita N, Kodama F, Kanamori H, Motomura S, Ishigatsubo Y. Prophylactic intrathecal methotrexate and hydrocortisone reduces central nervous system recurrence and improves survival in aggressive non-hodgkin lymphoma. Cancer. 2002; 95(3) 576-580
65 Tilly H, Lepage E, Coiffier B Groupe d'Etude des Lymphomes de l'Adulte et al. Intensive conventional chemotherapy (ACVBP regimen) compared with standard CHOP for poor-prognosis aggressive non-Hodgkin lymphoma. Blood. 2003; 102(13) 4284-4289
66 Feugier P, Virion J M, Tilly H et al.. Incidence and risk factors for central nervous system occurrence in elderly patients with diffuse large-B-cell lymphoma: influence of rituximab. Ann Oncol. 2004; 15(1) 129-133

Lawrence RechtM.D.

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