CNS involvement by non-Hodgkin's lymphoma. Response to a standard therapeutic protocol
I. Raz, T. Siegal, T. Siegal and A. Polliack
Treatment results of 31 episodes of CNS involvement by malignant lymphoma
diagnosed in 24 patients were studied. Leptomeningeal involvement occurred
in 16 patients, intracerebral invasion in eight patients, and epidural cord
compression in seven patients. Twelve patients with leptomeningeal
involvement treated with intraventricular methotrexate sodium achieved
complete CSF remission and ten patients' conditions improved
neurologically. Five of the patients with epidural cord compression were
ambulatory following treatment. Complete resolution of intracerebral
lymphoma was documented by computed tomographic scan in four patients. The
overall median survival was nine months, eight months for leptomeningeal
involvement, five months for intracerebral lymphoma, and 12 months for
patients with cord compression. Our results suggest that all forms of CNS
lymphoma usually respond well to therapy, life span is prolonged, and is
free of CNS disease until patients die of uncontrolled systemic lymphoma.
