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• W2245450168 abstract "8089 Background: Central nervous system (CNS) relapse is an uncommon but serious complication of non-Hodgkin lymphoma and usually occurs early in the disease course, suggesting subclinical disease at diagnosis. Several studies have demonstrated the superiority of FCM analysis of CSF, as compared to conventional cytology (CC), in detecting occult leptomeningeal disease in heterogeneous groups of aggressive lymphoma. Nevertheless, the clinical relevance of a positive FCM is still to be determined in DLBCL. Methods: We reviewed CSF samples from 114 patients (pts) with DLBCL (15% being transformed follicular lymphoma), analyzed both by FCM and CC, between 2005 and 2009. Ninety-three samples were from newly diagnosed (ND) pts and 21 from pts in relapse. The R-IPI in ND was very good (2%), good (42%) and poor (56%). First-line treatments included R-CHOP (n=81) and R- ACVBP (n=9) regimens with methotrexate intrathecal prophylaxis, and pts in relapse received several types of salvage treatments. A FCM+ did not influence treatment strategies. Results: Seventeen samples of the 114 were FCM+, versus 1 sample CC+ (this being also FCM+). In order not to overestimate the risk of CNS relapse, we excluded from the analysis pts with signs at presentation suggesting leptomeningeal disease (n=13). Therefore, within ND pts without neurological signs (n=86), 9 (10%) were FCM+, versus 4 FCM+ (27%) in the 15 pts in relapse. In the first group, 1/9 (11%) developed CNS relapse versus 0/4 (0%) in the second group. Within all pts without neurological signs (n=101), 4 (4%) relapsed in the CNS, with a median time to relapse of 5.2 months. In those, only 1/4 (25%) was FCM+ prior to relapse. Clinical features that showed an association with CNS relapse were: more than one extranodal site (ENS) of disease and the conjunction of elevated LDH and ENS>1 (p=0.04 and p=0.018, respectively). Conclusions: FCM gives far more positive results than CC, when analyzing CSF of pts with DLBCL (17/114 FCM+, versus 1/114 CC+). However, a positive FCM result did not translate into an increased relapse rate in the CNS, in this population. Therefore, FCM failed to have a predictive value in the occurrence of CNS relapse in DLBCL. No significant financial relationships to disclose." @default.
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• W2245450168 date "2010-05-20" @default.
• W2245450168 modified "2023-09-25" @default.
• W2245450168 title "Clinical relevance of a positive result in cerebrospinal fluid (CSF) by flow cytometry (FCM) in patients with diffuse large B-cell lymphoma (DLBCL)." @default.
• W2245450168 doi "https://doi.org/10.1200/jco.2010.28.15_suppl.8089" @default.
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