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Clinical characteristics and outcomes of patients with Hodgkin lymphoma with central nervous system involvement : An international multicenter collaboration

Cheah, Chan Y.; Bröckelmann, Paul J.; Chihara, Dai; Moskowitz, Alison J.; Engert, Andreas; Jerkeman, Mats LU ; El-Galaly, Tarec C.; Augustson, Bradley; Vose, Julie and Bartlett, Nancy L., et al. (2016) In American Journal of Hematology 91(9). p.894-899
Abstract

Central nervous system (CNS) involvement is rare in patients with Hodgkin lymphoma (HL). Thus, the clinical features and outcomes are not well described. Cases of histologically confirmed CNS HL diagnosed between 1995 and 2015 were retrospectively identified in institutional (n = 7), national (n = 2), and cooperative group (n = 1) databases. We screened 30,781 patients with HL in our combined databases and identified 21 patients meeting eligibility criteria, an estimated frequency of 0.07%. CNS involvement was present at initial diagnosis in 10 patients (48%) and a feature of relapsed/refractory disease in 11 (52%). Among these 11 patients, the median time from initial diagnosis of HL to development of CNS involvement was 1.9 years... (More)

Central nervous system (CNS) involvement is rare in patients with Hodgkin lymphoma (HL). Thus, the clinical features and outcomes are not well described. Cases of histologically confirmed CNS HL diagnosed between 1995 and 2015 were retrospectively identified in institutional (n = 7), national (n = 2), and cooperative group (n = 1) databases. We screened 30,781 patients with HL in our combined databases and identified 21 patients meeting eligibility criteria, an estimated frequency of 0.07%. CNS involvement was present at initial diagnosis in 10 patients (48%) and a feature of relapsed/refractory disease in 11 (52%). Among these 11 patients, the median time from initial diagnosis of HL to development of CNS involvement was 1.9 years (range 0.4–6.6) and the median number of prior lines of therapy was 2 (range 1–7). Altogether, treatments included radiation, multiagent systemic chemotherapy, combined modality therapy, and subtotal resection. The overall response rate was 65%. After a median follow-up of 3.6 years (range 0.8–13.2) from diagnosis of CNS HL, the median PFS and OS were 7.6 and 29 months, respectively. CNS involvement as a feature of relapsed/refractory disease was adversely prognostic for both PFS and OS; however, four patients remain alive and free of relapse at 7–78 months follow-up. CNS involvement in HL is exceedingly rare and has a distinct clinical presentation with predilection for parenchymal lesions with dural extension. Around one-quarter of patients, mostly with CNS involvement at initial HL diagnosis, experience prolonged disease-free survival. Am. J. Hematol. 91:894–899, 2016. © 2016 Wiley Periodicals, Inc.

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American Journal of Hematology
volume
91
issue
9
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6 pages
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John Wiley & Sons
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  • Scopus:84983036422
ISSN
0361-8609
DOI
10.1002/ajh.24429
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English
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9dc029bd-a3aa-4994-a7a0-716047bde6b2
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2016-10-28 11:51:02
@misc{9dc029bd-a3aa-4994-a7a0-716047bde6b2,
  abstract     = {<p>Central nervous system (CNS) involvement is rare in patients with Hodgkin lymphoma (HL). Thus, the clinical features and outcomes are not well described. Cases of histologically confirmed CNS HL diagnosed between 1995 and 2015 were retrospectively identified in institutional (n = 7), national (n = 2), and cooperative group (n = 1) databases. We screened 30,781 patients with HL in our combined databases and identified 21 patients meeting eligibility criteria, an estimated frequency of 0.07%. CNS involvement was present at initial diagnosis in 10 patients (48%) and a feature of relapsed/refractory disease in 11 (52%). Among these 11 patients, the median time from initial diagnosis of HL to development of CNS involvement was 1.9 years (range 0.4–6.6) and the median number of prior lines of therapy was 2 (range 1–7). Altogether, treatments included radiation, multiagent systemic chemotherapy, combined modality therapy, and subtotal resection. The overall response rate was 65%. After a median follow-up of 3.6 years (range 0.8–13.2) from diagnosis of CNS HL, the median PFS and OS were 7.6 and 29 months, respectively. CNS involvement as a feature of relapsed/refractory disease was adversely prognostic for both PFS and OS; however, four patients remain alive and free of relapse at 7–78 months follow-up. CNS involvement in HL is exceedingly rare and has a distinct clinical presentation with predilection for parenchymal lesions with dural extension. Around one-quarter of patients, mostly with CNS involvement at initial HL diagnosis, experience prolonged disease-free survival. Am. J. Hematol. 91:894–899, 2016. © 2016 Wiley Periodicals, Inc.</p>},
  author       = {Cheah, Chan Y. and Bröckelmann, Paul J. and Chihara, Dai and Moskowitz, Alison J. and Engert, Andreas and Jerkeman, Mats and El-Galaly, Tarec C. and Augustson, Bradley and Vose, Julie and Bartlett, Nancy L. and Villa, Diego and Connors, Joseph M. and Feldman, Tatyana and Pinnix, Chelsea C. and Milgrom, Sarah A. and Dabaja, Bouthaina and Oki, Yasuhiro and Fanale, Michelle A.},
  issn         = {0361-8609},
  language     = {eng},
  month        = {09},
  number       = {9},
  pages        = {894--899},
  publisher    = {ARRAY(0xc2ea698)},
  series       = {American Journal of Hematology},
  title        = {Clinical characteristics and outcomes of patients with Hodgkin lymphoma with central nervous system involvement : An international multicenter collaboration},
  url          = {http://dx.doi.org/10.1002/ajh.24429},
  volume       = {91},
  year         = {2016},
}