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Related Experiment Videos

Central nervous system involvement in indolent lymphomas.

G Spectre1, A Gural, G Amir

  • 1Department of Hematology, Hadassah-Hebrew University Hospital, Jerusalem, Israel 12000. galiaspectre@hotmail.com

Annals of Oncology : Official Journal of the European Society for Medical Oncology
|January 12, 2005
PubMed
Summary

Central nervous system (CNS) involvement is a rare complication of indolent non-Hodgkin

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Area of Science:

  • Hematology
  • Neurology
  • Oncology

Background:

  • Central nervous system (CNS) involvement is a known complication of aggressive non-Hodgkin's lymphomas (NHL).
  • CNS involvement is rarely reported in indolent lymphomas, typically occurring after histological transformation.
  • Previous large series reported CNS involvement in approximately 3% of indolent NHL cases.

Purpose of the Study:

  • To investigate the characteristics and clinical course of CNS involvement in patients with indolent B-cell lymphomas.
  • To highlight the rarity and unexpected nature of this complication in indolent NHL.

Main Methods:

  • Retrospective review of seven patients (six female, one male) with indolent B-cell lymphomas and CNS involvement.
  • Analysis of disease characteristics, neurological symptoms, and treatment outcomes.

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  • Evaluation of systemic and CNS lymphoma presentation, including histological subtypes and transformation.

    • Main Results:

    • Patients median age at diagnosis of systemic and CNS lymphoma was 60 and 63 years, respectively.
    • Histologies included small lymphocytic lymphoma, follicular lymphoma (grades I and II), and unclear low-grade histology.
    • Neurological symptoms varied, with parenchymal, leptomeningeal, or both types of involvement observed.
    • All patients had systemic lymphoma, mostly with bone marrow involvement; four transformed to high-grade histology.
    • Treatment involved systemic and intra-cerebrospinal fluid chemotherapy, with some receiving radiotherapy.
    • Five patients achieved CNS response, with a median survival of 2 years (range 1-9 years); three died of CNS disease.

    Conclusions:

    • CNS involvement is a rare and unexpected complication of indolent NHL.
    • It should be considered in the differential diagnosis for patients with new neurological signs.
    • This condition is treatable, and some patients experience a prolonged clinical course.