Skip to main content

Leptomeningeal Metastases from Leukemias and Lymphomas

  • Chapter
Leptomeningeal Metastases

Part of the book series: Cancer Treatment and Research ((CTAR,volume 125))

Abstract

Leptomeningeal dissemination of lymphoma and leukemia differs from that of solid tumors in a number of clinically important aspects. Specific histologic variants of lymphoma and leukemia have such a high incidence of cerebrospinal fluid (CSF) dissemination that assessing CSF cytology at diagnosis is crucial and prophylactic therapy of the CSF compartment is required. Furthermore, while the overall prognosis for patients with leptomeningeal metastases from leukemia and lymphoma is similar to solid tumors, selected patients have excellent response to therapy and attain durable remission. Therefore, aggressive treatment is warranted.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. DeAngelis LM. Current diagnosis and treatment of leptomeningeal metastasis. J Neurooncol 1998; 38:245–52.

    Article  PubMed  CAS  Google Scholar 

  2. Kaplan JG, DeSouza TG, Farkash A, et al. Leptomeningeal metastases: Comparison of clinical features and laboratory data of solid tumors, lymphomas and leukemias. J Neurooncol 1990; 9:225–9.

    Article  PubMed  CAS  Google Scholar 

  3. van Oostenbrugge RJ, Twijnstra A. Presenting features and value of diagnostic procedures in leptomeningeal metastases. Neurology 1999; 53:382–5.

    PubMed  Google Scholar 

  4. Freedman A, Nadler LM. Non-Hodgkin's Lymphomas. In: Cancer Medicine, 4th Edition, 1997. Holland J, Bast RC JR, Morton ML, Frei E III, Kufe DW, Weichselbaum RR (Eds). Williams & Wilkins, Baltimore, pp 2757–2795.

    Google Scholar 

  5. Cuttner J, Meyer R, Huang YP. Intercranial involvement in Hodgkin's disease. A report of 6 cases and review of the literature. Cancer 1979; 43:1497–1506.

    PubMed  CAS  Google Scholar 

  6. Perez-Jaffe LA, Salhany KE, Green RJ, et al. Cerebral spinal fluid involvement by Hodgkin's disease diagnosed by CSF cytology and immunocytochemistry. Diagn Cytopathol 1999; 20:219–223.

    Article  PubMed  CAS  Google Scholar 

  7. Bishop PC, Wilson WH, Pearson D, et al. CNS involvement in primary mediastinal large B-cell lymphoma. J Clin Oncol 1999; 17:2479–85.

    PubMed  CAS  Google Scholar 

  8. Recht L, Straus DJ, Cirrincione C, Thaler HT, Posner JB. Central nervous system metastases from non-Hodgkin's lymphoma: Treatment and prophylaxis. Am J Med 1988; 84:425–35.

    Article  PubMed  CAS  Google Scholar 

  9. Bollen EL, Brouwer RE, Hamers S, et al. Central nervous system relapse in non-Hodgkin's lymphoma. A single-center study of 532 patients. Arch Neurol 1997; 54:854–9.

    PubMed  CAS  Google Scholar 

  10. Ersboll J, Schultz HB, Thomsen BL, Keiding N, Nissen NI. Meningeal involvement in non-Hodgkin's lymphoma: symptoms, incidence, risk factors and treatment. Scand J Haematol 1985; 35:487–96.

    Article  PubMed  CAS  Google Scholar 

  11. Litam JP, Cabanillas F, Smith TL, Bodey GP, Freireich EJ. Central nervous system relapse in malignant lymphomas: risk factors and implications for prophylaxis. Blood 1979; 54:1249–57.

    PubMed  CAS  Google Scholar 

  12. Liang R, Chiu E, Loke SL. Secondary central nervous system involvement by non-Hodgkin's lymphoma: the risk factors. Hematol Oncol 1990; 8:141–5.

    PubMed  CAS  Google Scholar 

  13. Alvarnas JC, Negrin RS, Horning SJ, et al. High-dose therapy with hematopoietic cell transplantation for patients with central nervous system involvement by non-Hodgkin's lymphoma. Biol Blood Marrow Transplant 2000; 6:352–8.

    Article  PubMed  CAS  Google Scholar 

  14. van Besien K, Ha CS, Murphy S, et al. Risk factors, treatment, and outcome of central nervous system recurrence in adults with intermediate-grade and immunoblastic lymphoma. Blood 1998; 91:1178–84.

    PubMed  Google Scholar 

  15. Gomori JM, Heching N, Siegal T. Leptomeningeal metastases: evaluation by gadolinium enhanced spinal magnetic resonance imaging. J Neurooncol 1998; 36:55–60.

    Article  PubMed  CAS  Google Scholar 

  16. Collie DA, Sellar RJ, Steyn JP, Cull RE. The diagnostic yield of magnetic resonance imaging (MRI) of the brain and spine requested by general practitioners: comparison with hospital clinicians. Br J Gen Pract 1999; 49:559–61.

    PubMed  CAS  Google Scholar 

  17. Chamberlain M. Leptomeningeal Metastases. In: Cancer in the Nervous System. Levin V (Ed.), Churchill Livingstone, New York, 1996, pp 282–290.

    Google Scholar 

  18. Rhodes CH, Glantz MJ, Glantz L, et al. A comparison of polymerase chain reaction examination of cerebrospinal fluid and conventional cytology in the diagnosis of lymphomatous meningitis. Cancer 1996; 77:543–8.

    Article  PubMed  CAS  Google Scholar 

  19. Jeffery GM, Frampton CM, Legge HM, Hart DN. Cerebrospinal fluid B2-microglobulin levels in meningeal involvement by malignancy. Pathology 1990; 22:20–3.

    PubMed  CAS  Google Scholar 

  20. Chamberlain MC. Leptomeningeal metastases: A review of evaluation and treatment. J Neurooncol 1998; 37:271–84.

    Article  PubMed  CAS  Google Scholar 

  21. Paulus JA, Bos GM, Lowenberg B, Van Den Bent MJ. Treatment results and the prognosis in patients with localization of non-Hodgkin's lymphoma in the central nervous system. Ned Tijdschr Geneeskd 1998; 142:2196–200.

    PubMed  CAS  Google Scholar 

  22. Yoshida S, Morii K, Watanabe M, Saito T. Characteristic features of malignant lymphoma with central nervous system involvement. Surg Neurol 2000;53:163–7.

    Article  PubMed  CAS  Google Scholar 

  23. Magrath IT, Haddy TB, Adde MA. Treatment of patients with high-grade non-Hodgkin's lymphomas and central nervous system involvement: is radiation an essential component of therapy? Leuk Lymphoma 1996; 21:99–105.

    PubMed  CAS  Google Scholar 

  24. Philip T, Guglielmi C, Hagenbeek A, et al. Autologous bone marrow transplantation as compared with salvage chemotherapy in relapses of chemotherapy-sensitive non-Hodgkin's lymphoma. N Engl J Med 1995; 333:1540–5.

    Article  PubMed  CAS  Google Scholar 

  25. Williams CD, Pearce R, Taghipour G, et al. Autologous bone marrow transplantation for patients with non-Hodgkin's lymphoma and CNS involvement: Those transplanted with active CNS disease have a poor outcome—a report by the European Bone Marrow Transplant Lymphoma Registry. J Clin Oncol 1994; 12:2415–22.

    PubMed  CAS  Google Scholar 

  26. Rabkin CS, Yellin F. Cancer incidence in a population with a high prevalence of infection with human immunodeficiency virus type 1. J Natl Cancer Inst 1994; 86:1711–6.

    PubMed  CAS  Google Scholar 

  27. Taiwo BO. AIDS-related primary CNS lymphoma: A brief review. AIDS Read 2000; 10:486–91.

    PubMed  CAS  Google Scholar 

  28. Cingolani A, Gastaldi R, Fassone L, et al. Epstein-Barr virus infection is predictive of CNS involvement in systemic AIDS-related non-Hodgkin's lymphomas. J Clin Oncol 2000; 18:3325–30.

    PubMed  CAS  Google Scholar 

  29. DeAngelis LM, Wong E, Rosenblum M, Furneaux H. Epstein-Barr virus in acquired immune deficiency syndrome (AIDS) and non-AIDS primary central nervous system lymphoma. Cancer 1992; 70:1607–11.

    PubMed  CAS  Google Scholar 

  30. Desai J, Mitnick RJ, Henry DH, Llena J, Sparano JA. Patterns of central nervous system recurrence in patients with systemic human immunodeficiency virus-associated non-Hodgkin's lymphoma. Cancer 1999; 86:1840–7.

    Article  PubMed  CAS  Google Scholar 

  31. Goldstein JD, Dickson DW, Moser FG, et al. Primary central nervous system lymphoma in acquired immune deficiency syndrome. A clinical and pathologic study with results of treatment with radiation. Cancer 1991; 67:2756–65.

    PubMed  CAS  Google Scholar 

  32. Raez LE, Patel P, Feun L, et al. Natural history and prognostic factors for survival in patients with acquired immune deficiency syndrome (AIDS)-related primary central nervous system lymphoma (PCNSL). Crit Rev Oncol 1998; 9:199–208.

    CAS  Google Scholar 

  33. Chamberlain MC, Kormanik PA. AIDS-related central nervous system lymphomas. J Neurooncol 1999; 43:269–76.

    Article  PubMed  CAS  Google Scholar 

  34. Mahoney DH Jr, Shuster JJ, Nitschke R, et al. Intensification with intermediate-dose intravenous methotrexate is effective therapy for children with lower-risk B-precursor acute lymphoblastic leukemia: A Pediatric Oncology Group study. J Clin Oncol 2000; 18:1285–94.

    PubMed  CAS  Google Scholar 

  35. Ortega JA, Nesbit ME, Sather HN, et al. Long-term evaluation of a CNS prophylaxis trial—treatment comparisons and outcome after CNS relapse in childhood ALL: A report from the Childrens Cancer Study Group. J Clin Oncol 1987; 5:1646–54.

    PubMed  CAS  Google Scholar 

  36. Ritchey AK, Pollock BH, Lauer SJ, et al. Improved survival of children with isolated CNS relapse of acute lymphoblastic leukemia: A pediatric oncology group study. J Clin Oncol 1999; 17:3745–52.

    PubMed  CAS  Google Scholar 

  37. Smith M, Arthur D, Camitta B, et al. Uniform approach to risk classification and treatment assignment for children with acute lymphoblastic leukemia. J Clin Oncol 1996; 14:18–24.

    PubMed  CAS  Google Scholar 

  38. Schrappe M, Reiter A, Riehm H. Prophylaxis and treatment of neoplastic meningeosis in childhood acute lymphoblastic leukemia. J Neurooncol 1998; 38:159–65.

    Article  PubMed  CAS  Google Scholar 

  39. Mahmoud HH, Rivera GK, Hancock ML, et al. Low leukocyte counts with blast cells in cerebrospinal fluid of children with newly diagnosed acute lymphoblastic leukemia. N Engl J Med 1993; 329:314–9.

    Article  PubMed  CAS  Google Scholar 

  40. Schrappe M, Beck J, Brandeis WE, et al. Treatment of acute lymphoblastic leukemia in childhood and adolescence: results of the multicenter therapy study ALL-BFM 81. Klin Padiatr 1987; 199:133–50.

    Article  PubMed  CAS  Google Scholar 

  41. Pullen J, Boyett J, Shuster J, et al. Extended triple intrathecal chemotherapy trial for prevention of CNS relapse in good-risk and poor-risk patients with B-progenitor acute lymphoblastic leukemia: a Pediatric Oncology Group study. J Clin Oncol 1993; 11:839–49.

    PubMed  CAS  Google Scholar 

  42. Tubergen DG, Gilchrist GS, O'Brien RT, et al. Prevention of CNS disease in intermediate-risk acute lymphoblastic leukemia: Comparison of cranial radiation and intrathecal methotrexate and the importance of systemic therapy: A Childrens Cancer Group report. J Clin Oncol 1993; 11:520–6.

    PubMed  CAS  Google Scholar 

  43. Conter V, Arico M, Valsecchi MG, et al. Long-term results of the Italian Association of Pediatric Hematology and Oncology (AIEOP) acute lymphoblastic leukemia studies, 1982–1995. Leukemia 2000; 14:2196–204.

    Article  PubMed  CAS  Google Scholar 

  44. Nachman J, Sather HN, Cherlow JM, et al. Response of children with high-risk acute lymphoblastic leukemia treated with and without cranial irradiation: A report from the Children's Cancer Group. J Clin Oncol 1998; 16:920–30.

    PubMed  CAS  Google Scholar 

  45. Nachman JB, Sather HN, Sensel MG, et al. Augmented post-induction therapy for children with high-risk acute lymphoblastic leukemia and a slow response to initial therapy. N Engl J Med 1998; 338:1663–71.

    Article  PubMed  CAS  Google Scholar 

  46. Hoelzer DF. Therapy of the newly diagnosed adult with acute lymphoblastic leukemia. Hematol Oncol Clin North Am 1993; 7:139–60.

    PubMed  CAS  Google Scholar 

  47. Cortes JE, Kantarjian HM. Acute lymphoblastic leukemia. A comprehensive review with emphasis on biology and therapy. Cancer 1995; 76:2393–417.

    PubMed  CAS  Google Scholar 

  48. Gokbuget N, Hoelzer D. Meningeosis leukemia in adult acute lymphoblastic leukaemia. J Neurooncol 1998; 38:167–80.

    Article  PubMed  CAS  Google Scholar 

  49. Thompson CB, Sanders JE, Flournoy N, Buckner CD, Thomas ED. The risks of central nervous system relapse and leukoencephalopathy in patients receiving marrow transplants for acute leukemia. Blood 1986; 67:195–9.

    PubMed  CAS  Google Scholar 

  50. Cortes J, Aguayo A, Kantarjian H. Chronic leukemias. In: Cancer Management: A Multidisciplinary Approach. Pazdur R, Coia LR, Hoskins WJ, Wagmen LD (Eds.) PRR, Melville, NY, 2000, pp 657–680.

    Google Scholar 

  51. Sacchi S, Kantarjian HM, O'Brien S, et al. Chronic myelogenous leukemia in nonlymphoid blastic phase: Analysis of the results of first salvage therapy with three different treatment approaches for 162 patients. Cancer 1999; 86:2632–41.

    Article  PubMed  CAS  Google Scholar 

  52. Morrison C, Shah S, Flinn IW. Leptomeningeal involvement in chronic lymphocytic leukemia. Cancer Pract 1998; 6:223–8.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2005 Springer Science+Business Media, Inc.

About this chapter

Cite this chapter

Nolan, C.P., Abrey, L.E. (2005). Leptomeningeal Metastases from Leukemias and Lymphomas. In: Abrey, L.E., Chamberlain, M.C., Engelhard, H.H. (eds) Leptomeningeal Metastases. Cancer Treatment and Research, vol 125. Springer, Boston, MA. https://doi.org/10.1007/0-387-24199-X_4

Download citation

  • DOI: https://doi.org/10.1007/0-387-24199-X_4

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-0-387-24198-2

  • Online ISBN: 978-0-387-24199-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics