CNS involvement by non-Hodgkin's lymphoma. Response to a standard therapeutic protocol

Treatment results of 31 episodes of CNS involvement by malignant lymphoma diagnosed in 24 patients were studied. Leptomeningeal involvement occurred in 16 patients, intracerebral invasion in eight patients, and epidural cord compression in seven patients. Twelve patients with leptomeningeal involvement treated with intraventricular methotrexate sodium achieved complete CSF remission and ten patients' conditions improved neurologically. Five of the patients with epidural cord compression were ambulatory following treatment. Complete resolution of intracerebral lymphoma was documented by computed tomographic scan in four patients. The overall median survival was nine months, eight months for leptomeningeal involvement, five months for intracerebral lymphoma, and 12 months for patients with cord compression. Our results suggest that all forms of CNS lymphoma usually respond well to therapy, life span is prolonged, and is free of CNS disease until patients die of uncontrolled systemic lymphoma.