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MeSH: nádory centrálního nervového systému-mortalita

8 záznamů v Medvik Filtry

Článek

Primární lymfom centrální nervové soustavy

Móciková, Heidi, 1964-
Autor Autorita Hematologická klinika FNKV a 3. LF UK, Praha

Acta medicinae. 2022 ; 11 (11-13) : 88-89.

ISSN 1805-398X
Medvik
Zdroj

Článek

Characteristics and outcome in patients with central nervous system involvement treated in European pediatric acute myeloid leukemia study groups

Pediatric blood & cancer. 2017 ; 64 (12) : . [pub] 20170609

Pediatr Blood Cancer
ISSN 1545-5017
Medvik
Zdroj

BACKGROUND: There is no consensus on the treatment for pediatric patients with acute myeloid leukemia and initial central nervous system (CNS) involvement. METHODS: To evaluate different CNS-directed treatment options (intrathecal [IT] therapy, CNS irradiation, hematopoietic stem cell transplantation [HSCT]), 261 patients (excluding acute promyelocytic leukemia) with initial CNS involvement treated in trials with similar intensive chemotherapy by four cooperative European study groups (1998-2013) were studied and compared with CNS-negative patients from the Berlin-Frankfurt-Münster group. RESULTS: Patient characteristics in the different study groups were comparable. Young age, high white blood cell count, extramedullary involvement other than the CNS, monoblastic morphology, and inv(16) were associated with CNS involvement (each P < 0.0001). There were no major differences in outcome between the study groups. The cumulative incidence of relapse (CIR) regarding the CNS was higher in initially CNS-positive versus initially CNS-negative patients (all: 8 ± 2% vs. 3 ± 1%, P(Gray) = 0.001; isolated: 4 ± 1% vs. 1 ± 0%, P(Gray) = 0.03). However, global outcome of the CNS-positive cohort (overall survival, 64 ± 3%; event-free survival 48 ± 3%; and CIR 33% ± 3%) did not differ significantly from CNS-negative patients. Risk groups defined by cytogenetics were of likewise prognostic significance in CNS-positive and -negative patients. CNS treatment with cranial irradiation was not superior compared to IT therapy and systemic chemotherapy (± HSCT). CONCLUSION: Although CNS relapses occurred more frequently in initially CNS-positive patients, their global outcome was similar as in CNS-negative patients. Intensified IT therapy was heterogeneous; however, at least eight applications, preferably with triple IT chemotherapy, seem to be appropriate to accompany dose-intensive systemic chemotherapy.

MeSH
akutní myeloidní leukemie mortalita terapie MeSH
dítě MeSH
kojenec MeSH
kraniální ozáření MeSH
lidé MeSH
mladiství MeSH
nádory centrálního nervového systému mortalita terapie MeSH
novorozenec MeSH
předškolní dítě MeSH
proporcionální rizikové modely MeSH
recidiva MeSH
sekundární malignity epidemiologie MeSH
transplantace hematopoetických kmenových buněk MeSH
výsledek terapie MeSH
Check Tag
dítě MeSH
kojenec MeSH
lidé MeSH
mladiství MeSH
novorozenec MeSH
předškolní dítě MeSH
Publikační typ
časopisecké články MeSH

Článek

Central nervous system involvement by multiple myeloma: A multi-institutional retrospective study of 172 patients in daily clinical practice

American journal of hematology. 2016 ; 91 (6) : 575-80. [pub] 20160424

Am J Hematol
ISSN 1096-8652
Medvik
Zdroj

The multicenter retrospective study conducted in 38 centers from 20 countries including 172 adult patients with CNS MM aimed to describe the clinical and pathological characteristics and outcomes of patients with multiple myeloma (MM) involving the central nervous system (CNS). Univariate and multivariate analyses were performed to identify prognostic factors for survival. The median time from MM diagnosis to CNS MM diagnosis was 3 years. Thirty-eight patients (22%) were diagnosed with CNS involvement at the time of initial MM diagnosis and 134 (78%) at relapse/progression. Upon diagnosis of CNS MM, 97% patients received initial therapy for CNS disease, of which 76% received systemic therapy, 36% radiotherapy and 32% intrathecal therapy. After a median follow-up of 3.5 years, the median overall survival (OS) from the onset of CNS involvement for the entire group was 7 months. Untreated and treated patients had median OS of 2 and 8 months, respectively (P < 0.001). At least one previous line of therapy for MM before the diagnosis of CNS disease and >1 cytogenetic abnormality detected by FISH were independently associated with worse OS. The median OS for patients with 0, 1 and 2 of these risk factors were 25 months, 5.5 months and 2 months, respectively (P < 0.001). Neurological manifestations, not considered chemotherapy-related, observed at any time after initial diagnosis of MM should raise a suspicion of CNS involvement. Although prognosis is generally poor, the survival of previously untreated patients and patients with favorable cytogenetic profile might be prolonged due to systemic treatment and/or radiotherapy. Am. J. Hematol. 91:575-580, 2016. © 2016 Wiley Periodicals, Inc.

MeSH
analýza přežití MeSH
antitumorózní látky terapeutické užití MeSH
chromozomální aberace MeSH
dospělí MeSH
kombinovaná terapie MeSH
lidé středního věku MeSH
lidé MeSH
míra přežití MeSH
mnohočetný myelom komplikace mortalita patologie terapie MeSH
nádory centrálního nervového systému diagnóza mortalita sekundární terapie MeSH
prognóza MeSH
radioterapie MeSH
retrospektivní studie MeSH
senioři nad 80 let MeSH
senioři MeSH
výsledek terapie MeSH
Check Tag
dospělí MeSH
lidé středního věku MeSH
lidé MeSH
mužské pohlaví MeSH
senioři nad 80 let MeSH
senioři MeSH
ženské pohlaví MeSH
Publikační typ
časopisecké články MeSH
multicentrická studie MeSH

Článek

Role of rituximab in treatment of patients with primary central nervous system lymphoma: a retrospective analysis of the Czech lymphoma study group registry

Leukemia & lymphoma. 2016 ; 57 (12) : 2777-2783. [pub] 20160418

Leuk Lymphoma
ISSN 1042-8194
Medvik
Zdroj

We have investigated whether the addition of rituximab to methotrexate, procarbazine, vincristine, radiotherapy and cytarabine was associated with improved outcome of primary central nervous system lymphomas (PCNSL). Of 164 patients, 49 received rituximab. Median age was 63 years, median Karnofsky performance score (KPS) was 60 and median follow-up of living patients was 59.5 months. 1- and 2-year PFS were 49.7 and 37.9%, 1- and 2-year OS were 57.0 and 45.3%. Median progression-free survival (PFS), but not overall survival (OS) was significantly better for patients treated with rituximab (22.9 vs. 10.9 months, p = 0.037). In multivariate analysis, age ≤70 years and KPS ≥90 were predictive for PFS and OS, rituximab was an independent prognostic factor for PFS only. In landmark analyses, rituximab was not found beneficial for long-term survivors and no group particularly benefited from rituximab. In conclusion, addition of rituximab was associated with improved PFS, but not OS in this unselected cohort of PCNSL patients.