Skip to main content
SpringerLink
Log in

Central Nervous System Recurrence in the Primary Mediastinal Large B-Cell Lymphoma: Treatment

  • Chapter
  • First Online:
Tumors of the Central Nervous System, Volume 9

Part of the book series: Tumors of the Central Nervous System ((TCNS,volume 9))

Abstract

Primary mediastinal large B-cell lymphoma (PMLBL) is a rare subtype of diffuse large B-cell lymphoma (DLBL), and it is recently recognized as a clinicopathological entity. Treatment of PMLBL with combination chemotherapy and radiotherapy has shown good outcome. Central nervous system (CNS) relapse of aggressive lymphoma is rare but has poor prognosis. A strategy for CNS prophylaxis and treatment in DLBL remains to be clarified because most of studies performed till date have been small scale and retrospective and have variable outcomes. Involvement of specific sites such as the testis, breast, nasal/paranasal sinuses and bone marrow is associated with a high rate of CNS relapse, which may require CNS prophylaxis. Further, CNS recurrence has been reported in 2–11% of PMLBL patients, and measures for the CNS prophylaxis have not been discussed for this new disease entity. Therefore, in this manuscript, we have reviewed CNS relapse and prophylaxis in PMLBL.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  • Abou-Elella AA, Weisenburger DD, Vose JM, Kollath JP, Lynch JC, Bast MA, Bierman PJ, Greiner TC, Chan WC, Armitage JO (1999) Primary mediastinal large B-cell lymphoma: a clinicopathologic study of 43 patients from the Nebraska Lymphoma Study Group. J Clin Oncol 17:784–790

    PubMed  CAS  Google Scholar 

  • Abrey LE, Moskowitz CH, Mason WP, Crump M, Stewart D, Forsyth P, Paleologos N, Correa DD, Anderson ND, Caron D, Zelenetz A, Nimer SD, DeAngelis LM (2003) Intensive methotrexate and cytarabine followed by high-dose chemotherapy with autologous stem-cell rescue in patients with newly diagnosed primary CNS lymphoma: an intent-to-treat analysis. J Clin Oncol 21:4151–4156

    Article  PubMed  CAS  Google Scholar 

  • Batchelor T, Carson K, O’Neill A, Grossman SA, Alavi J, New P, Hochberg F, Priet R (2003) Treatment of primary CNS lymphoma with methotrexate and deferred radiotherapy: a report of NABTT 96–07. J Clin Oncol 21:1044–1049

    Article  PubMed  CAS  Google Scholar 

  • Bishop PC, Wilson WH, Pearson D, Janik J, Jaffe ES, Elwood PC (1999) CNS involvement in primary ­mediastinal large B-cell lymphoma. J Clin Oncol 17:2479–2485

    PubMed  CAS  Google Scholar 

  • Cheung CW, Burton C, Smith P, Linch DC, Hoskin PJ, Ardeshna KM (2005) Central nervous system chemoprophylaxis in non-Hodgkin lymphoma: current practice in the UK. Br J Haematol 131:193–200

    Article  PubMed  CAS  Google Scholar 

  • Colocci N, Glantz M, Recht L (2004) Prevention and treatment of central nervous system involvement by non-Hodgkin’s lymphoma: a review of the literature. Semin Neurol 24:395–404

    Article  PubMed  Google Scholar 

  • Colombat P, Lemevel A, Bertrand P, Delwail V, Rachieru P, Brion A, Berthou C, Bay JO, Delepine R, Desablens B, Camilleri-Broët S, Linassier C, Lamy T (2006) High-dose chemotherapy with autologous stem cell transplantation as first-line therapy for primary CNS lymphoma in patients younger than 60 years: a multicenter phase II study of the GOELAMS group. Bone Marrow Transplant 38:417–420

    Article  PubMed  CAS  Google Scholar 

  • Doolittle ND, Abrey LE, Shenkier TN, Tali S, Bromberg JE, Neuwelt EA, Soussain C, Jahnke K, Johnston P, Illerhaus G, Schiff D, Batchelor T, Montoto S, Kraemer DF, Zucca E (2008) Brain parenchyma involvement as isolated central nervous system relapse of systemic non-Hodgkin lymphoma: an International Primary CNS Lymphoma Collaborative Group report. Blood 111:1085–1093

    Article  PubMed  CAS  Google Scholar 

  • Etienne B, Guillaud PH, Loire R, Coiffier B, Berger F, Cordier JF (1999) Aggressive primary mediastinal non-Hodgkin’s lymphomas: a study of 29 cases. Eur Respir J 13:1133–1138

    Article  PubMed  CAS  Google Scholar 

  • Ferreri AJ, Reni M, Pasini F, Calderoni A, Tirelli U, Pivnik A, Aondio GM, Ferrarese F, Gomez H, Ponzoni M, Borisch B, Berger F, Chassagne C, Iuzzolino P, Carbone A, Weis J, Pedrinis E, Motta T, Jouvet A, Barbui T, Cavalli F, Blay JY (2002) A multicenter study of treatment of primary CNS lymphoma. Neurology 58:1513–1520

    Article  PubMed  CAS  Google Scholar 

  • Ferreri AJ, Reni M, Foppoli M, Martelli M, Pangalis GA, Frezzato M, Cabras MG, Fabbri A, Corazzelli G, Ilariucci F, Rossi G, Soffietti R, Stelitano C, Vallisa D, Zaja F, Zoppegno L, Aondio GM, Avvisati G, Balzarotti M, Brandes AA, Fajardo J, Gomez H, Guarini A, Pinotti G, Rigacci L, Uhlmann C, Picozzi P, Vezzulli P, Ponzoni M, Zucca E, Caligaris-Cappio F, Cavalli F, International Extranodal Lymphoma Study Group (IELSG) (2009) High-dose cytarabine plus high-dose methotrexate versus high-dose methotrexate alone in patients with primary CNS lymphoma: a randomised phase 2 trial. Lancet 374:1512–1520

    Article  PubMed  CAS  Google Scholar 

  • Guha-Thakurta N, Damek D, Pollack C, Hochberg FH (1999) Intravenous methotrexate as initial treatment for primary central nervous system lymphoma: response to therapy and quality of life of patients. J Neurooncol 43:259–268

    Article  PubMed  CAS  Google Scholar 

  • Haioun C, Besson C, Lepage E, Thieblemont C, Simon D, Rose C, Tilly H, Sonet A, Lederlin P, Attal M, Brière J, Reyes F (2000) Incidence and risk factors of central nervous system relapse in histologically aggressive non-Hodgkin’s lymphoma uniformly treated and receiving intrathecal central nervous system prophylaxis: a GELA study on 974 patients. Groupe d’Etudes des Lymphomes de l’Adulte. Ann Oncol 11:685–690

    Article  PubMed  CAS  Google Scholar 

  • Herrlinger U, Küker W, Uhl M, Blaicher HP, Karnath HO, Kanz L, Bamberg M, Weller M, Neuro-Oncology Working Group of the German Society (2005) NOA-03 trial of high-dose methotrexate in primary central nervous system lymphoma: final report. Ann Neurol 57:843–847

    Article  PubMed  CAS  Google Scholar 

  • Hollender A, Kvaloy S, Nome O, Skovlund E, Lote K, Holte H (2002) Central nervous system involvement following diagnosis of non-Hodgkin’s lymphoma: a risk model. Ann Oncol 13:1099–1107

    Article  PubMed  CAS  Google Scholar 

  • Illerhaus G, Marks R, Ihorst G, Guttenberger R, Ostertag C, Derigs G, Frickhofen N, Feuerhake F, Volk B, Finke J (2006) High-dose chemotherapy with autologous stem-cell transplantation and hyperfractionated radiotherapy as first-line treatment of primary CNS lymphoma. J Clin Oncol 24:3865–3870

    Article  PubMed  CAS  Google Scholar 

  • Kirn D, Mauch P, Shaffer K, Pinkus G, Shipp MA, Kaplan WD, Tung N, Wheeler C, Beard CJ, Canellos GP (1993) Large-cell and immunoblastic lymphoma of the mediastinum: prognostic features and treatment outcome in 57 patients. J Clin Oncol 11:1336–1343

    PubMed  CAS  Google Scholar 

  • Lazzarino M, Orlandi E, Paulli M, Boveri E, Morra E, Brusamolino E, Kindl S, Rosso R, Astori C, Buonanno MC (1993) Primary mediastinal B-cell lymphoma with sclerosis: an aggressive tumor with distinctive clinical and pathologic features. J Clin Oncol 11:2306–2313

    PubMed  CAS  Google Scholar 

  • Morris PG, Abrey LE (2009) Therapeutic challenges in primary CNS lymphoma. Lancet Neurol 8:581–592

    Article  PubMed  CAS  Google Scholar 

  • Rubenstein JL, Fridlyand J, Abrey L, Shen A, Karch J, Wang E, Issa S, Damon L, Prados M, McDermott M, O’Brien J, Haqq C, Shuman M (2007) Phase I study of intraventricular administration of rituximab in patients with recurrent CNS and intraocular lymphoma. J Clin Oncol 25:1350–1356

    Article  PubMed  CAS  Google Scholar 

  • Sasaki M, Sugimoto K, Masuda A, Tsukune Y, Yahata Y, Komatsu N (2010) Early CNS relapse in a good-risk primary mediastinal large B-cell lymphoma after combined chemo- and radio-therapy. J Neurooncol 99:295–296

    Article  PubMed  Google Scholar 

  • Schulz H, Pels H, Schmidt-Wolf I, Zeelen U, Germing U, Engert A (2004) Intraventricular treatment of relapsed central nervous system lymphoma with the anti-CD20 antibody rituximab. Haematologica 89:753–754

    PubMed  CAS  Google Scholar 

  • Shah GD, Yahalom J, Correa DD, Lai RK, Raizer JJ, Schiff D, LaRocca R, Grant B, DeAngelis LM, Abrey LE (2007) Combined immunochemotherapy with reduced whole-brain radiotherapy for newly diagnosed primary CNS lymphoma. J Clin Oncol 25:4730–4735

    Article  PubMed  CAS  Google Scholar 

  • Stefoni V, Broccoli A, Pellegrini C, Derenzini E, Fina M, Zinzani PL (2009) CNS recurrence of primary mediastinal large b-cell lymphoma after complete remission. J Neurooncol 95:135–139

    Article  PubMed  Google Scholar 

  • Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J, Vardiman JW (2008) WHO classification of tumours of haematopoietic and lymphoid tissues, 4th edn. International Agency for Research on Cancer, Lyon, pp 250–251

    Google Scholar 

  • Tilly H, Lepage E, Coiffier B, Blanc M, Herbrecht R, Bosly A, Attal M, Fillet G, Guettier C, Molina TJ, Gisselbrecht C, Reyes F, Groupe d’Etude des Lymphomes de l’Adulte (2003) Intensive conventional chemotherapy (ACVBP regimen) compared with standard CHOP for poor-prognosis aggressive non-Hodgkin lymphoma. Blood 102:4284–4289

    Article  PubMed  CAS  Google Scholar 

  • Todeschini G, Ambrosetti A, Meneghini V, Pizzolo G, Menestrina F, Chilosi M, Benedetti F, Veneri D, Cetto GL, Perona G (1990) Mediastinal large-B-cell lymphoma with sclerosis: a clinical study of 21 patients. J Clin Oncol 8:804–808

    PubMed  CAS  Google Scholar 

  • Tomita N, Kodama F, Kanamori H, Motomura S, Ishigatsubo Y (2002) Prophylactic intrathecal methotrexate and hydrocortisone reduces central nervous system recurrence and improves survival in aggressive non-Hodgkin lymphoma. Cancer 95:576–580

    Article  PubMed  CAS  Google Scholar 

  • van Besien K, Ha CS, Murphy S, McLaughlin P, Rodriguez A, Amin K, Forman A, Romaguera J, Hagemeister F, Younes A, Bachier C, Sarris A, Sobocinski KS, Cox JD, Cabanillas F (1998) Risk factors, treatment, and outcome of central nervous system recurrence in adults with intermediate-grade and immunoblastic lymphoma. Blood 91:1178–1184

    PubMed  Google Scholar 

  • Zinzani PL, Martelli M, Poletti V, Vitolo U, Gobbi PG, Chisesi T, Barosi G, Ferreri AJ, Marchetti M, Pimpinelli N, Tura S, Italian Society of Hematology, Italian Society of Experimental Hematology, Italian Group for Bone Marrow Transplantation (2008) Practice guidelines for the management of extranodal non-Hodgkin’s lymphomas of adult non-immunodeficient patients. Part I: primary lung and mediastinal lymphomas. A project of the Italian Society of Hematology, the Italian Society of Experimental Hematology and the Italian Group for Bone Marrow Transplantation. Haematologica 93:1364–1371

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Hematology, Department of Internal Medicine, School of Medicine, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, 113-8421, Tokyo, Japan

    Makoto Sasaki & Koichi Sugimoto

Authors
  1. Makoto Sasaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Koichi Sugimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Makoto Sasaki .

Editor information

Editors and Affiliations

  1. , Kean University, Room 213, Library building, Morris Avenue 1000, Union, 07083, New Jersey, USA

    M.A. Hayat

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer Science+Business Media Dordrecht

About this chapter

Cite this chapter

Sasaki, M., Sugimoto, K. (2012). Central Nervous System Recurrence in the Primary Mediastinal Large B-Cell Lymphoma: Treatment. In: Hayat, M. (eds) Tumors of the Central Nervous System, Volume 9. Tumors of the Central Nervous System, vol 9. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-5488-1_3

Download citation

  • DOI: https://doi.org/10.1007/978-94-007-5488-1_3

  • Published:

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-007-5487-4

  • Online ISBN: 978-94-007-5488-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation