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Related Concept Videos

Secondary Lymphoid Organs01:15

Secondary Lymphoid Organs

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Secondary organs, including lymph nodes, the spleen, and mucosa-associated lymphoid tissue (MALT), work harmoniously to protect us from disease and infection.
The spleen is a vital organ in the lymphatic system, nestled in the upper left side of the abdomen. It is composed of two primary regions: the red pulp and the white pulp, each having distinct functions. The red pulp performs a significant role in blood filtration. It efficiently purges the blood of old or damaged red blood cells and...
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Updated: Mar 9, 2026

VDJ-Seq: Deep Sequencing Analysis of Rearranged Immunoglobulin Heavy Chain Gene to Reveal Clonal Evolution Patterns of B Cell Lymphoma
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Anatomical Localization-Based Analysis of Relapsed Secondary Central Nervous System Aggressive B-Cell Lymphoma

Izel Okcu1,2, Yucai Wang1, Zhuo Li3

  • 1Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA.

Hematological Oncology
|March 7, 2026
PubMed
Summary
This summary is machine-generated.

Leptomeningeal involvement in relapsed secondary central nervous system lymphoma (R-SCNSL) significantly worsens survival outcomes. Anatomical classification of R-SCNSL subtypes is crucial for predicting patient prognosis and guiding treatment strategies.

Keywords:
CNS relapsediffuse large B‐cell lymphomahigh grade B‐cell lymphomaleptomeningeal involvementparenchymal involvement

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Area of Science:

  • Hematology
  • Oncology
  • Neurology

Background:

  • Relapsed secondary central nervous system lymphoma (R-SCNSL) presents a significant clinical challenge.
  • Understanding prognostic factors and anatomical patterns of R-SCNSL is critical for improving patient outcomes.
  • Leptomeningeal involvement is a known adverse prognostic factor in CNS lymphomas.

Purpose of the Study:

  • To analyze the impact of anatomical localization and clinical features on survival in patients with R-SCNSL.
  • To evaluate the prognostic significance of leptomeningeal involvement in R-SCNSL.
  • To assess the utility of an anatomical classification system for R-SCNSL management.

Main Methods:

  • Retrospective analysis of 162 patients with R-SCNSL.
  • Classification of R-SCNSL based on anatomical involvement (parenchymal vs. leptomeningeal) and systemic relapse.
  • Multivariable analysis to identify independent predictors of overall survival (OS) and progression-free survival (PFS).

Main Results:

  • Leptomeningeal involvement independently predicted inferior OS (HR=1.98), associated with a 98% increase in hazard of death compared to parenchymal relapse.
  • Anatomical classification into four subtypes (P-CNS, P-concomitant, LM-CNS, LM-concomitant) significantly impacted OS and PFS (p < 0.001).
  • Two-year OS rates ranged from 58.2% (P-CNS) to 7.1% (LM-concomitant), highlighting distinct prognostic groups.

Conclusions:

  • Leptomeningeal involvement is a critical adverse prognostic factor in R-SCNSL.
  • The proposed anatomical classification system effectively stratifies R-SCNSL patients by prognosis.
  • Findings support the clinical application of anatomical classification for optimizing R-SCNSL management and treatment decisions.