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. 2011 Jul;22(7):1636-1643.
doi: 10.1093/annonc/mdq645. Epub 2011 Jan 10.

Elevated LDH and paranasal sinus involvement are risk factors for central nervous system involvement in patients with peripheral T-cell lymphoma

J H Yi  1 , J H Kim  1 , K K Baek  1 , T Lim  1 , D J Lee  1 , Y C Ahn  2 , K Kim  1 , S J Kim  1 , Y H Ko  3 , W S Kim  4
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Elevated LDH and paranasal sinus involvement are risk factors for central nervous system involvement in patients with peripheral T-cell lymphoma

J H Yi et al. Ann Oncol. 2011 Jul.

Abstract

Background: The incidence and risk factors of central nervous system (CNS) involvement in peripheral T-cell lymphomas (PTCLs) are still unclear.

Patients and methods: We analyzed 228 patients with PTCLs, excluding cases of extranodal natural killer/T-cell lymphoma and primary cutaneous T-cell lymphoma, by retrospectively collecting the clinical features and outcomes of the patients.

Results: Twenty events (8.77%, 20/228) of CNS involvement were observed during a median follow-up period of 13.9 months (range 0.03-159.43). Based on univariate analysis, elevated serum lactate dehydrogenase (LDH) level [P = 0.019, relative risk (RR) 5.904, 95% confidence interval (CI) 1.334-26.123] and involvement of the paranasal sinus (P = 0.032, RR 3.137, 95% CI 1.105-8.908) adversely affect CNS involvement. In multivariate analysis, both were independently poor prognostic factors for CNS relapse [elevated LDH level: P = 0.011, hazard ratio (HR) 6.716, 95% CI 1.548-29.131; involvement of the paranasal sinus: P = 0.008, HR 3.784, 95% CI 1.420-10.083]. The survival duration of patients with CNS involvement was significantly shorter than that of the patients without CNS involvement (P = 0.009), with median overall survival of 7.60 months (95% CI of 4.92-10.28) versus 27.43 months (95% CI of 0.00-57.38), respectively.

Conclusions: Elevated LDH level and involvement of the paranasal sinus are two risk factors for CNS involvement in patients with PTCLs. Considering the poor prognoses after CNS relapse, prophylaxis should be considered with the presence of any risk factor.

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Figures

Figure 1.
Figure 1.
Patient cohort [*other T-cell neoplasms include other T-cell leukemias, natural killer (NK) cell leukemia, lymphoblastic lymphoma, extranodal NK/T-cell lymphoma, primary cutaneous peripheral T-cell lymphomas, mycosis fungoides, Sezary syndrome and chronic lymphoproliferative disorder of NK cells; **PTCL-NOS, peripheral T-cell lymphoma, not otherwise specified; AITL, angioimmunoblastic T-cell lymphoma; HSTL, hepatosplenic T-cell lymphoma; EATL, enteropathy-associated T-cell lymphoma; ALCL, anaplastic large cell lymphoma; †Kim et al. 20].
Figure 2.
Figure 2.
Overall survival according to central nervous system involvement.
Figure 3.
Figure 3.
Cumulative incidence of central nervous system relapse according to number of the risk factors.
See this image and copyright information in PMC

References

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