Clinical characteristics and outcomes of patients with Hodgkin lymphoma with central nervous system involvement

An international multicenter collaboration

Chan Y. Cheah, Paul J. Bröckelmann, Dai Chihara, Alison J. Moskowitz, Andreas Engert, Mats Jerkeman, Tarec C. El-Galaly, Bradley Augustson, Julie Marie Vose, Nancy L. Bartlett, Diego Villa, Joseph M. Connors, Tatyana Feldman, Chelsea C. Pinnix, Sarah A. Milgrom, Bouthaina Dabaja, Yasuhiro Oki, Michelle A. Fanale

Research output: Contribution to journalArticle

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Abstract

Central nervous system (CNS) involvement is rare in patients with Hodgkin lymphoma (HL). Thus, the clinical features and outcomes are not well described. Cases of histologically confirmed CNS HL diagnosed between 1995 and 2015 were retrospectively identified in institutional (n = 7), national (n = 2), and cooperative group (n = 1) databases. We screened 30,781 patients with HL in our combined databases and identified 21 patients meeting eligibility criteria, an estimated frequency of 0.07%. CNS involvement was present at initial diagnosis in 10 patients (48%) and a feature of relapsed/refractory disease in 11 (52%). Among these 11 patients, the median time from initial diagnosis of HL to development of CNS involvement was 1.9 years (range 0.4–6.6) and the median number of prior lines of therapy was 2 (range 1–7). Altogether, treatments included radiation, multiagent systemic chemotherapy, combined modality therapy, and subtotal resection. The overall response rate was 65%. After a median follow-up of 3.6 years (range 0.8–13.2) from diagnosis of CNS HL, the median PFS and OS were 7.6 and 29 months, respectively. CNS involvement as a feature of relapsed/refractory disease was adversely prognostic for both PFS and OS; however, four patients remain alive and free of relapse at 7–78 months follow-up. CNS involvement in HL is exceedingly rare and has a distinct clinical presentation with predilection for parenchymal lesions with dural extension. Around one-quarter of patients, mostly with CNS involvement at initial HL diagnosis, experience prolonged disease-free survival. Am. J. Hematol. 91:894–899, 2016.

Original languageEnglish (US)
Pages (from-to)894-899
Number of pages6
JournalAmerican Journal of Hematology
Volume91
Issue number9
DOIs
StatePublished - Sep 1 2016

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Hodgkin Disease
Central Nervous System
Databases
Combined Modality Therapy
Disease-Free Survival
Radiation
Recurrence
Drug Therapy
Therapeutics

ASJC Scopus subject areas

  • Hematology

Cite this

Clinical characteristics and outcomes of patients with Hodgkin lymphoma with central nervous system involvement : An international multicenter collaboration. / Cheah, Chan Y.; Bröckelmann, Paul J.; Chihara, Dai; Moskowitz, Alison J.; Engert, Andreas; Jerkeman, Mats; El-Galaly, Tarec C.; Augustson, Bradley; Vose, Julie Marie; Bartlett, Nancy L.; Villa, Diego; Connors, Joseph M.; Feldman, Tatyana; Pinnix, Chelsea C.; Milgrom, Sarah A.; Dabaja, Bouthaina; Oki, Yasuhiro; Fanale, Michelle A.

In: American Journal of Hematology, Vol. 91, No. 9, 01.09.2016, p. 894-899.

Research output: Contribution to journalArticle

Cheah, CY, Bröckelmann, PJ, Chihara, D, Moskowitz, AJ, Engert, A, Jerkeman, M, El-Galaly, TC, Augustson, B, Vose, JM, Bartlett, NL, Villa, D, Connors, JM, Feldman, T, Pinnix, CC, Milgrom, SA, Dabaja, B, Oki, Y & Fanale, MA 2016, 'Clinical characteristics and outcomes of patients with Hodgkin lymphoma with central nervous system involvement: An international multicenter collaboration', American Journal of Hematology, vol. 91, no. 9, pp. 894-899. https://doi.org/10.1002/ajh.24429
Cheah, Chan Y. ; Bröckelmann, Paul J. ; Chihara, Dai ; Moskowitz, Alison J. ; Engert, Andreas ; Jerkeman, Mats ; El-Galaly, Tarec C. ; Augustson, Bradley ; Vose, Julie Marie ; Bartlett, Nancy L. ; Villa, Diego ; Connors, Joseph M. ; Feldman, Tatyana ; Pinnix, Chelsea C. ; Milgrom, Sarah A. ; Dabaja, Bouthaina ; Oki, Yasuhiro ; Fanale, Michelle A. / Clinical characteristics and outcomes of patients with Hodgkin lymphoma with central nervous system involvement : An international multicenter collaboration. In: American Journal of Hematology. 2016 ; Vol. 91, No. 9. pp. 894-899.
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abstract = "Central nervous system (CNS) involvement is rare in patients with Hodgkin lymphoma (HL). Thus, the clinical features and outcomes are not well described. Cases of histologically confirmed CNS HL diagnosed between 1995 and 2015 were retrospectively identified in institutional (n = 7), national (n = 2), and cooperative group (n = 1) databases. We screened 30,781 patients with HL in our combined databases and identified 21 patients meeting eligibility criteria, an estimated frequency of 0.07{\%}. CNS involvement was present at initial diagnosis in 10 patients (48{\%}) and a feature of relapsed/refractory disease in 11 (52{\%}). Among these 11 patients, the median time from initial diagnosis of HL to development of CNS involvement was 1.9 years (range 0.4–6.6) and the median number of prior lines of therapy was 2 (range 1–7). Altogether, treatments included radiation, multiagent systemic chemotherapy, combined modality therapy, and subtotal resection. The overall response rate was 65{\%}. After a median follow-up of 3.6 years (range 0.8–13.2) from diagnosis of CNS HL, the median PFS and OS were 7.6 and 29 months, respectively. CNS involvement as a feature of relapsed/refractory disease was adversely prognostic for both PFS and OS; however, four patients remain alive and free of relapse at 7–78 months follow-up. CNS involvement in HL is exceedingly rare and has a distinct clinical presentation with predilection for parenchymal lesions with dural extension. Around one-quarter of patients, mostly with CNS involvement at initial HL diagnosis, experience prolonged disease-free survival. Am. J. Hematol. 91:894–899, 2016.",
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T1 - Clinical characteristics and outcomes of patients with Hodgkin lymphoma with central nervous system involvement

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AU - Chihara, Dai

AU - Moskowitz, Alison J.

AU - Engert, Andreas

AU - Jerkeman, Mats

AU - El-Galaly, Tarec C.

AU - Augustson, Bradley

AU - Vose, Julie Marie

AU - Bartlett, Nancy L.

AU - Villa, Diego

AU - Connors, Joseph M.

AU - Feldman, Tatyana

AU - Pinnix, Chelsea C.

AU - Milgrom, Sarah A.

AU - Dabaja, Bouthaina

AU - Oki, Yasuhiro

AU - Fanale, Michelle A.

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N2 - Central nervous system (CNS) involvement is rare in patients with Hodgkin lymphoma (HL). Thus, the clinical features and outcomes are not well described. Cases of histologically confirmed CNS HL diagnosed between 1995 and 2015 were retrospectively identified in institutional (n = 7), national (n = 2), and cooperative group (n = 1) databases. We screened 30,781 patients with HL in our combined databases and identified 21 patients meeting eligibility criteria, an estimated frequency of 0.07%. CNS involvement was present at initial diagnosis in 10 patients (48%) and a feature of relapsed/refractory disease in 11 (52%). Among these 11 patients, the median time from initial diagnosis of HL to development of CNS involvement was 1.9 years (range 0.4–6.6) and the median number of prior lines of therapy was 2 (range 1–7). Altogether, treatments included radiation, multiagent systemic chemotherapy, combined modality therapy, and subtotal resection. The overall response rate was 65%. After a median follow-up of 3.6 years (range 0.8–13.2) from diagnosis of CNS HL, the median PFS and OS were 7.6 and 29 months, respectively. CNS involvement as a feature of relapsed/refractory disease was adversely prognostic for both PFS and OS; however, four patients remain alive and free of relapse at 7–78 months follow-up. CNS involvement in HL is exceedingly rare and has a distinct clinical presentation with predilection for parenchymal lesions with dural extension. Around one-quarter of patients, mostly with CNS involvement at initial HL diagnosis, experience prolonged disease-free survival. Am. J. Hematol. 91:894–899, 2016.

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