Pretreatment intratumoral susceptibility signals correlate with response to high-dose methotrexate and progression-free survival in primary central nervous system lymphoma

Publication date: Available online 16 August 2019Source: Journal of Clinical NeuroscienceAuthor(s): Shoichi Deguchi, Kazuaki Nakashima, Koji Muramatsu, Koichi Mitsuya, Takuma Oishi, Kensei Shirata, Nakamasa Hayashi, Takashi Sugino, Masahiro Endo, Yoko NakasuAbstractWe aimed to estimate the frequency of intratumoral susceptibility signals (ITSS) in susceptibility-weighted imaging (SWI) in consecutive patients with primary central nervous system lymphoma (PCNSL), and to determine if pretreatment heterogeneity of PCNSL is predictive of response to chemotherapy by using ITSS on SWI. We retrospectively examined 29 immunocompetent patients with PCNSL who underwent SWI–MRI before treatment. A univariate analysis was conducted with Fisher’s exact test. Progression free survival (PFS) was calculated by the Kaplan–Meier method and compared by the log rank test. The patients, including 16 males, were initially treated at a median age of 69 years. All tissue types were diffuse large B-cell lymphoma. Nineteen patients (66%) presented lesions with ITSS. Sixteen patients (55%) received initial treatment with R-MTX (rituximab plus high-dose methotrexate). Seven out of nine patients with ITSS exhibited a poor response, whereas all seven without ITSS exhibited a good response to R-MTX. Regarding the absence of ITSS, the sensitivity, specificity, and diagnostic accuracy for a good response to R-MTX were 0.78, 1.00, and 0.88, respectively. Patients without ITSS showed signifi...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research

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AbstractMonomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) is a provisional entity in the 2017 World Health Organization classifications. To further elucidate the clinicopathologic features of this new disease, we carried out a retrospective, multicenter analysis of 42 patients with MEITL. The median age of the patients was 59  years (range, 20–84 years), and 27 patients (64 %) were male. Thirty-two patients (76 %) were Ann-Arbor stages I–II and 28 (67 %) were Lugano stages I–II1&2. The most frequent site of involvement was the jejunum (N = 21). Most case...
Source: Annals of Hematology - Category: Hematology Source Type: research
Condition:   Primary Central Nervous System Lymphoma Intervention:   Drug: IBER salvage chemotherapy followed by ibrutinib maintenance therapy Sponsor:   Deok-Hwan Yang Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
We report a rare case of a primary intraventricular CNS classical HL-PTLD in a male patient, 18 years following renal transplantation. The location allowed for safe neurosurgical intervention which resolved the symptom of elevated intracranial pressure and allowed for induction of a Rituximab-based chemotherapy regimen. Both the ventricular location of the PTLD and Hodgkin Lymphoma PTLD are themselves individually quite rare and have not previously been reported together. The unique location allowed safe neurosurgical intervention which quickly resolved the symptom of elevated intracranial pressure and allowed for induct...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
Condition:   Primary Central Nervous System Lymphoma Intervention:   Drug: IBER salvage chemotherapy followed by ibrutinib maintenance therapy Sponsor:   Deok-Hwan Yang Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Priyanka A Patel, Asha S Anand, Sonia K Parikh, Akash D Patel, Rahul S KulkarniJournal of Pediatric Neurosciences 2019 14(2):86-89Burkitt lymphoma is a high-grade B-cell lymphoma with aggressive course of disease and primarily systemic nodal involvement. Primary Burkitt lymphoma with isolated central nervous system (CNS) involvement and that too in pediatric population has been rarely reported. Here, we present a case of a primary Burkitt lymphoma involving brain in an human immunodeficiency virus–positive pediatric patient who was on antiretroviral therapy. Currently, there are no established protocols or guidelines...
Source: Journal of Pediatric Neurosciences - Category: Neuroscience Authors: Source Type: research
ConclusionsResults indicated improvement in cognitive function up to 3  years post-treatment, but a decline at later time points and an increase in brain structure abnormalities in both groups. The findings suggest that rdWBRT and HDC-ASCT may be associated with delayed neurotoxicity in progression-free patients and underscore the need for long-term follow-up to chara cterize cognitive dysfunction in PCNSL patients.
Source: Journal of Neuro-Oncology - Category: Cancer & Oncology Source Type: research
AbstractPurpose of reviewThis review focuses on the findings of recent randomized prospective trials evaluating new therapeutic options for primary central nervous system lymphoma (PCNSL) in first-line treatment and on the most promising novel agents.Recent findingsThe current standard treatment of newly diagnosed PCNSL has long been depending on high-dose methotrexate (HD-MTX) –based polychemotherapy followed by whole-brain radiotherapy (WBRT). Recent randomized trials have provided evidence that high-dose chemotherapy with autologous stem cell transplantation (ASCT) is a valuable alternative option to WBRT as conso...
Source: Current Treatment Options in Neurology - Category: Neurology Source Type: research
In conclusion, NGR-hTNF/R-CHOP was safe in these heavily pretreated patients. NGR-hTNF enhanced vascular permeability specifically in tumoral/peritumoral areas, which resulted in fast and sustained responses.
Source: Blood - Category: Hematology Authors: Tags: Lymphoid Neoplasia, Clinical Trials and Observations Source Type: research
Conclusion: Ophthalmologists should know that patient followed up with sarcoid uveitis can develop a primary vitreoretinal diffuse large B-cell lymphoma. PMID: 31268740 [PubMed - as supplied by publisher]
Source: Ocular Immunology and Inflammation - Category: Allergy & Immunology Tags: Ocul Immunol Inflamm Source Type: research
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