Late relapse in primary central nervous system lymphoma: Clonal persistence Journal Article
| Authors: | Nayak, L.; Hedvat, C.; Rosenblum, M. K.; Abrey, L. E.; De Angelis, L. M. |
| Article Title: | Late relapse in primary central nervous system lymphoma: Clonal persistence |
| Abstract: | Recurrence of primary central nervous system lymphoma (PCNSL) after initial diagnosis and treatment occurs within 2 years in most patients, and relapse after 5 years is rare. We evaluated late relapse in our PCNSL population. We identified 10 patients from our database of 378 patients (268 achieved a complete response and 230 had relapse) with PCNSL who had relapse ≥5 years after initial diagnosis. At initial diagnosis, their median age was 47 years; all patients had brain involvement and achieved a complete response to initial therapy (9 received high-dose methotrexate). Median time to first relapse was 7.4 years (range, 5.2-14.6 y). Eight patients had relapse in the brain, 1 had ocular relapse, and 1 had a systemic relapse. The histologic specimens at initial diagnosis and relapse were examined for clonal rearrangement in 3 patients; 1 had the identical clone at initial diagnosis and relapse 13.8 years later, and the other 2 were uninformative. All patients received salvage therapy (9 received systemic therapy and 1 received intraocular chemotherapy. Nine patients achieved a complete response to salvage therapy and 1 achieved a partial response. Four patients had relapse a second time. The median progression-free survival after first relapse was 31 months (range, 7.9-82.4). Late relapses accounted for 4% of all recurrences (10 of 230 patients) in our PCNSL population. Long-term persistence of the PCNSL clone was observed in one patient. Patients with late relapses have a good response to salvage therapy and prolonged survival. © The Author(s) 2011. |
| Keywords: | adult; cancer survival; clinical article; human tissue; treatment response; aged; prednisone; salvage therapy; doxorubicin; cancer combination chemotherapy; systemic therapy; cancer patient; cancer radiotherapy; primary central nervous system lymphoma; methotrexate; rituximab; temozolomide; brain radiation; drug megadose; progression free survival; cyclophosphamide; vincristine; medical record review; retrospective study; reference database; histology; cancer relapse; brain cancer; high-dose methotrexate; late relapse; eye cancer |
| Journal Title: | Neuro-Oncology |
| Volume: | 13 |
| Issue: | 5 |
| ISSN: | 1522-8517 |
| Publisher: | Oxford University Press |
| Date Published: | 2011-05-01 |
| Start Page: | 525 |
| End Page: | 529 |
| Language: | English |
| DOI: | 10.1093/neuonc/nor014 |
| PROVIDER: | scopus |
| PUBMED: | 21372070 |
| PMCID: | PMC3093334 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 17 August 2011" - "CODEN: NEURJ" - "Source: Scopus" |
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
-
576De Angelis -
126Hedvat -
424Rosenblum -
18Nayak -
278
Abrey
Related MSK Work