CENTRAL NERVOUS SYSTEM RELAPSE IN UNFAVOURABLE-HISTOLOGY NON-HODGKIN'S LYMPHOMA: IS PROPHYLAXIS INDICATED?

Gerhard J. Johnson, Martin M. Oken, James R. Anderson, Michael J. O'Connell, John H. Glick

Research output: Contribution to journalShort surveypeer-review

44 Scopus citations

Abstract

In 2 randomised, prospective Eastern Cooperative Oncology Group trials, the frequency of central nervous system (CNS) involvement after chemotherapy in 347 adults with stage III and IV unfavourable-histology, non-Hodgkin's lymphoma was 8·4%. The frequency varied from 0% in diffuse mixed lymphoma to >30% in lymphoblastic and diffuse-undifferentiated lymphoma. Of the 42% of patients who achieved complete remission after chemotherapy, CNS involvement developed in 5·4% during relapse, but in only 2·7% was the CNS the sole site of relapse. CNS lymphoma arose in 6·6% of 197 patients with diffuse histiocytic lymphoma, but in only 1 subject (1%) was the CNS the sole site of relapse. Therefore, CNS prophylaxis is not indicated for the common diffuse-histology subtypes of adult non-Hodgkin's lymphoma including diffuse-histiocytic, diffusemixed and diffuse poorly differentiated lymphocytic lymphoma. The relatively high frequency of CNS lymphoma in lymphoblastic and diffuse undifferentiated lymphoma justify further studies of CNS prophylaxis.

Original languageEnglish (US)
Pages (from-to)685-687
Number of pages3
JournalThe Lancet
Volume324
Issue number8404
DOIs
StatePublished - Sep 22 1984

Bibliographical note

Funding Information:
We thank the Department of Infectious Diseases, Ruchill Hospital; colleagues in other hospitals for information about their patients; the Greater Glasgow Health Board, Glasgow District Council, Strathclyde Regional Council, and the Common Services Agency for access to data; Ms Ann Jones, Ms Pauline McLaughlan, Ms Patricia Burnett, and Ms Margaret Miller for home visits and record-keeping; and Mr C. Harvey for assistance with depriva- tion data. A. M. received a Junior Fellowship in Community Medicine from the Scottish Home and Health Department, and G. T. S. received support from the World Health Organisation (European Regional Office).

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