Abstract
BackgroundLeptomeningeal metastasis is an uncommon but devastating complication. The incidence of non-Hodgkin’s lymphoma has been increasing in recent decades, due to the poor central nervous system penetration of drugs and the prolonged overall survival of patients, leptomeningeal metastases has gradually increased over time. Patients with leptomeningeal metastases have short survival durations and poor quality of life; there are few studies about non-Hodgkin’s lymphoma with leptomeningeal metastases. We investigated characteristics and outcomes of non-Hodgkin’s lymphoma patients with leptomeningeal metastases.MethodsThis study included 27 non-Hodgkin’s lymphoma patients with leptomeningeal metastases diagnosed at Tianjin Medical University Cancer Institute and Hospital between 2013 and 2016. Statistical analysis was performed to investigate the overall survival of non-Hodgkin’s lymphoma with leptomeningeal metastases.ResultsDiffuse large B cell lymphoma was the most common cancer subtype (21/27, 78%), and more than half of the patients showed extranodal involvement (18/27, 67%). Survival analysis has shown extranodal involvement (P = 0.0205), International Prognostic Index (P = 0.0112), performance status (P < 0.0001), parenchymal involvement (P = 0.0330) and received radiotherapy (P = 0.0056) were predictive factors of prognosis for these patients with leptomeningeal metastases. Cox regression analysis has shown patients with concurrent parenchymal involvement and received radiotherapy are correlated with good prognosis.ConclusionsGiven the small number of patients who were included, this study exhibited limitations with respect to analytical power and the random selection of patients. Nevertheless, this investigation revealed characteristics of non-Hodgkin’s lymphoma patients with leptomeningeal metastases and suggested that such patients could benefit from multimodal therapy.
Highlights
Non-Hodgkin’s lymphoma (NHL) is a highly heterogeneous group of hematological tumors with many subtypes that range from indolent to highly aggressive
Some clinical studies of diffuse large B cell lymphoma (DLBCL) [3, 4], addition of rituximab to chemotherapy reduced the incidence of central nervous system (CNS) disease, but the benefit from adding rituximab to CHOP is limited, CNS relapse still a clinical challenge
Leptomeningeal metastases (LM) is a devastating condition that refers to involvement of the leptomeninges or cerebrospinal fluid (CSF) in the context of any malignant cancer
Summary
Non-Hodgkin’s lymphoma (NHL) is a highly heterogeneous group of hematological tumors with many subtypes that range from indolent to highly aggressive. The incidence of non-Hodgkin’s lymphoma has been increasing in recent decades, due to the poor central nervous system penetration of drugs and the prolonged overall survival of patients, leptomeningeal metastases has gradually increased over time. Survival analysis has shown extranodal involvement (P = 0.0205), International Prognostic Index (P = 0.0112), performance status (P < 0.0001), parenchymal involvement (P = 0.0330) and received radiotherapy (P = 0.0056) were predictive factors of prognosis for these patients with leptomeningeal metastases. Conclusions Given the small number of patients who were included, this study exhibited limitations with respect to analytical power and the random selection of patients This investigation revealed characteristics of non-Hodgkin’s lymphoma patients with leptomeningeal metastases and suggested that such patients could benefit from multimodal therapy
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