CENTRAL NERVOUS-SYSTEM RELAPSE IN MALIGNANT-LYMPHOMAS - RISK-FACTORS AND IMPLICATIONS FOR PROPHYLAXIS

  • 1 January 1979
    • journal article
    • research article
    • Vol. 54  (6) , 1249-1257
Abstract
Records of 292 patients with malignant lymphoma other than Hodgkin''s disease, registered in the protocols from 1967-1977, were reviewed to identify those with CNS involvement. Thirty-one patients had this complication. Patients with a diffuse histology had a higher frequency of CNS recurrences (27/174 = 16%) in contrast to only 4/118 (3%) for those with nodular types. If only patients with diffuse histology in CR [complete remission] were considered, frequency of CNS relapse was 13.5% (13/98). Risk factors that predict for the development of this complication were studied using multivariate analysis. Diffuse poorly differentiated lymphocytic and diffuse undifferentiated lymphomas were associated with high risk of CNS relapse. Prior chemotherapy, bone marrow involvement, age < 35 and extranodal disease were also identified as high-risk factors. Using the information generated by a logistic regression model, patients with malignant lymphoma of diffuse type could be classified into 3 categories when 1st seen: low-risk group, intermediate and high-risk group. CNS prophylaxis was recommended for the intermediate and high-risk group, while only close follow-up was advised for the low-risk group patients who have one adverse characteristic.