CNS prophylaxis in diffuse large B-cell lymphoma: If, when, how and for whom?

Blood Reviews

Volumn 26, Issue 3, 2012, Pages 97-106

  Siegal, Tali ^a   Goldschmidt, Neta ^a  

^a HADASSAH HEBREW UNIVERSITY MEDICAL CENTER   (Israel)

Author keywords

Brain; Cerebrospinal fluid; CNS prophylaxis; CNS relapse; High dose chemotherapy; Intrathecal chemotherapy; Leptomeningeal; Lymphoma; Methotrexate

Indexed keywords

BLEOMYCIN; CHEMOKINE; CISPLATIN; CXCL13 CHEMOKINE; CXCL19 CHEMOKINE; CYCLOPHOSPHAMIDE; CYTARABINE; DEXAMETHASONE; DOXORUBICIN; ETOPOSIDE; FLUOROURACIL; IFOSFAMIDE; METHOTREXATE; METHYLPREDNISOLONE; MITOXANTRONE; PREDNISONE; PROCARBAZINE; RITUXIMAB; STROMAL CELL DERIVED FACTOR 1; UNCLASSIFIED DRUG; VINCRISTINE; VINDESINE;

ACUTE LEUKEMIA; ACUTE LYMPHOBLASTIC LEUKEMIA; ARTICLE; BRAIN RADIATION; BURKITT LYMPHOMA; CANCER COMBINATION CHEMOTHERAPY; CANCER RELAPSE; CENTRAL NERVOUS SYSTEM DISEASE; CEREBROSPINAL FLUID CYTOLOGY; CHEMOPROPHYLAXIS; CHILDHOOD LEUKEMIA; CLONAL VARIATION; CONTINUOUS INFUSION; DRUG MEGADOSE; FLOW CYTOMETRY; HIGH RISK PATIENT; HUMAN; LARGE CELL LYMPHOMA; LEPTOMENINX; LYMPHATIC LEUKEMIA; LYMPHOBLASTOMA; MULTIPLE CYCLE TREATMENT; PRIORITY JOURNAL; RECURRENCE RISK; RISK FACTOR;

ANTINEOPLASTIC AGENTS; ANTINEOPLASTIC COMBINED CHEMOTHERAPY PROTOCOLS; BRAIN; CENTRAL NERVOUS SYSTEM NEOPLASMS; CLINICAL TRIALS AS TOPIC; FEMALE; HUMANS; INJECTIONS, SPINAL; LONGITUDINAL STUDIES; LYMPHOMA, LARGE B-CELL, DIFFUSE; MALE; RECURRENCE; TIME FACTORS; TREATMENT FAILURE;

EID: 84859211271     PISSN: 0268960X     EISSN: 15321681     Source Type: Journal    
DOI: 10.1016/j.blre.2011.12.001     Document Type: Article

References (89)

1. Bokstein F., Lossos A., Lossos I.S., Siegal T. Central nervous system relapse of systemic non-Hodgkin's lymphoma: results of treatment based on high-dose methotrexate combination chemotherapy. Leuk Lymphoma 2002, 43:587-593.
2. Doolittle N.D., Abrey L.E., Shenkier T.N., Tali S., Bromberg J.E., Neuwelt E.A., et al. Brain parenchyma involvement as isolated central nervous system relapse of systemic non-Hodgkin lymphoma: an International Primary CNS Lymphoma Collaborative Group report. Blood 2008, 111:1085-1093.
3. Haioun C., Besson C., Lepage E., Thieblemont C., Simon D., Rose C., et al. Incidence and risk factors of central nervous system relapse in histologically aggressive non-Hodgkin's lymphoma uniformly treated and receiving intrathecal central nervous system prophylaxis: a GELA study on 974 patients. Groupe d'Etudes des Lymphomes de l'Adulte. Ann Oncol 2000, 11:685-690.
4. Hollender A., Kvaloy S., Nome O., Skovlund E., Lote K., Holte H. Central nervous system involvement following diagnosis of non-Hodgkin's lymphoma: a risk model. Ann Oncol 2002, 13:1099-1107.
5. Shimazu Y., Notohara K., Ueda Y. Diffuse large B-cell lymphoma with central nervous system relapse: prognosis and risk factors according to retrospective analysis from a single-center experience. Int J Hematol 2009, 89:577-583.
6. Zinzani P.L., Magagnoli M., Frezza G., Prologo G., Gherlinzoni F., Bendandi M., et al. Isolated central nervous system relapse in aggressive non-Hodgkin's lymphoma: the Bologna experience. Leuk Lymphoma 1999, 32:571-576.
7. Ferreri A.J., Assanelli A., Crocchiolo R., Ciceri F. Central nervous system dissemination in immunocompetent patients with aggressive lymphomas: incidence, risk factors and therapeutic options. Hematol Oncol 2009, 27:61-70.
8. van Besien K., Ha C.S., Murphy S., McLaughlin P., Rodriguez A., Amin K., et al. Risk factors, treatment, and outcome of central nervous system recurrence in adults with intermediate-grade and immunoblastic lymphoma. Blood 1998, 91:1178-1184.
9. Bernstein J.I., Coleman C.N., Strickler J.G., Dorfman R.F., Rosenberg S.A. Combined modality therapy for adults with small noncleaved cell lymphoma (Burkitt's and non-Burkitt's types). J Clin Oncol 1986, 4:847-858.
10. Blum K.A., Lozanski G., Byrd J.C. Adult Burkitt leukemia and lymphoma. Blood 2004, 104:3009-3020.
11. Rizzieri D.A., Johnson J.L., Niedzwiecki D., Lee E.J., Vardiman J.W., Powell B.L., et al. Intensive chemotherapy with and without cranial radiation for Burkitt leukemia and lymphoma: final results of Cancer and Leukemia Group B Study 9251. Cancer 2004, 100:1438-1448.
12. Haddy T.B., Adde M.A., Magrath I.T. CNS involvement in small noncleaved-cell lymphoma: is CNS disease per se a poor prognostic sign?. J Clin Oncol 1991, 9:1973-1982.
13. Kujawski L.A., Longo W.L., Williams E.C., Turman N.J., Brandt N., Mosher D.F., et al. A 5-drug regimen maximizing the dose of cyclophosphamide is effective therapy for adult Burkitt or Burkitt-like lymphomas. Cancer Invest 2007, 25:87-93.
14. Arkenau H.T., Chong G., Cunningham D., Watkins D., Agarwal R., Sirohi B., et al. The role of intrathecal chemotherapy prophylaxis in patients with diffuse large B-cell lymphoma. Ann Oncol 2007, 18:541-545.
15. Bjorkholm M., Hagberg H., Holte H., Kvaloy S., Teerenhovi L., Anderson H., et al. Central nervous system occurrence in elderly patients with aggressive lymphoma and a long-term follow-up. Ann Oncol 2007, 18:1085-1089.
16. Boehme V., Schmitz N., Zeynalova S., Loeffler M., Pfreundschuh M. CNS events in elderly patients with aggressive lymphoma treated with modern chemotherapy (CHOP-14) with or without rituximab: an analysis of patients treated in the RICOVER-60 trial of the German High-Grade Non-Hodgkin Lymphoma Study Group (DSHNHL). Blood 2009, 113:3896-3902.
17. Boehme V., Zeynalova S., Kloess M., Loeffler M., Kaiser U., Pfreundschuh M., et al. Incidence and risk factors of central nervous system recurrence in aggressive lymphoma-a survey of 1693 patients treated in protocols of the German High-Grade Non-Hodgkin's Lymphoma Study Group (DSHNHL). Ann Oncol 2007, 18:149-157.
18. Bos G.M., van Putten W.L., van der Holt B., van den Bent M., Verdonck L.F., Hagenbeek A. For which patients with aggressive non-Hodgkin's lymphoma is prophylaxis for central nervous system disease mandatory? Dutch HOVON Group. Ann Oncol 1998, 9:191-194.
19. Feugier P., Virion J.M., Tilly H., Haioun C., Marit G., Macro M., et al. Incidence and risk factors for central nervous system occurrence in elderly patients with diffuse large-B-cell lymphoma: influence of rituximab. Ann Oncol 2004, 15:129-133.
20. Tilly H., Lepage E., Coiffier B., Blanc M., Herbrecht R., Bosly A., et al. Intensive conventional chemotherapy (ACVBP regimen) compared with standard CHOP for poor-prognosis aggressive non-Hodgkin lymphoma. Blood 2003, 102:4284-4289.
21. Villa D., Connors J.M., Shenkier T.N., Gascoyne R.D., Sehn L.H., Savage K.J. Incidence and risk factors for central nervous system relapse in patients with diffuse large B-cell lymphoma: the impact of the addition of rituximab to CHOP chemotherapy. Ann Oncol 2010, 21:1046-1052.
22. Bollen E.L., Brouwer R.E., Hamers S., Hermans J., Kluin M., Sankatsing S.U., et al. Central nervous system relapse in non-Hodgkin lymphoma. A single-center study of 532 patients. Arch Neurol 1997, 54:854-859.
23. Fonseca R., Habermann T.M., Colgan J.P., O'Neill B.P., White W.L., Witzig T.E., et al. Testicular lymphoma is associated with a high incidence of extranodal recurrence. Cancer 2000, 88:154-161.
24. Gleissner B., Chamberlain M. Treatment of CNS dissemination in systemic lymphoma. J Neurooncol 2007, 84:107-117.
25. Hollender A., Kvaloy S., Lote K., Nome O., Holte H. Prognostic factors in 140 adult patients with non-Hodgkin's lymphoma with systemic central nervous system (CNS) involvement. A single centre analysis. Eur J Cancer 2000, 36:1762-1768.
26. Hasselblom S., Ridell B., Wedel H., Norrby K., Sender Baum M., Ekman T. Testicular lymphoma-a retrospective, population-based, clinical and immunohistochemical study. Acta Oncol 2004, 43:758-765.
27. Jahnke K., Thiel E., Martus P., Schwartz S., Korfel A. Retrospective study of prognostic factors in non-Hodgkin lymphoma secondarily involving the central nervous system. Ann Hematol 2006, 85:45-50.
28. Zucca E., Conconi A., Mughal T.I., Sarris A.H., Seymour J.F., Vitolo U., et al. Patterns of outcome and prognostic factors in primary large-cell lymphoma of the testis in a survey by the International Extranodal Lymphoma Study Group. J Clin Oncol 2003, 21:20-27.
29. Bernstein S.H., Unger J.M., Leblanc M., Friedberg J., Miller T.P., Fisher R.I. Natural history of CNS relapse in patients with aggressive non-Hodgkin's lymphoma: a 20-year follow-up analysis of SWOG 8516-the Southwest Oncology Group. J Clin Oncol 2009, 27:114-119.
30. Tai W.M., Chung J., Tang P.L., Koo Y.X., Hou X., Tay K.W., et al. Central nervous system (CNS) relapse in diffuse large B cell lymphoma (DLBCL): pre- and post-rituximab. Ann Hematol 2011, 90:809-818.
31. MacKintosh F.R., Colby T.V., Podolsky W.J., Burke J.S., Hoppe R.T., Rosenfelt F.P., et al. Central nervous system involvement in non-Hodgkin's lymphoma: an analysis of 105 cases. Cancer 1982, 49:586-595.
32. Tomita N., Kodama F., Sakai R., Koharasawa H., Hattori M., Taguchi J., et al. Predictive factors for central nervous system involvement in non-Hodgkin's lymphoma: significance of very high serum LDH concentrations. Leuk Lymphoma 2000, 38:335-343.
33. Lee K.W., Yi J., Choi I.S., Kim J.H., Bang S.M., Kim D.W., et al. Risk factors for poor treatment outcome and central nervous system relapse in diffuse large B-cell lymphoma with bone marrow involvement. Ann Hematol 2009, 88:829-838.
34. Yamamoto W., Tomita N., Watanabe R., Hattori Y., Nakajima Y., Hyo R., et al. Central nervous system involvement in diffuse large B-cell lymphoma. Eur J Haematol 2010, 85:6-10.
35. Herrlinger U., Glantz M., Schlegel U., Gisselbrecht C., Cavalli F. Should intra-cerebrospinal fluid prophylaxis be part of initial therapy for patients with non-Hodgkin lymphoma: what we know, and how we can find out more. Semin Oncol 2009, 36:S25-S34.
36. Hill Q.A., Owen R.G. CNS prophylaxis in lymphoma: who to target and what therapy to use. Blood Rev 2006, 20:319-332.
37. Pui C.H., Thiel E. Central nervous system disease in hematologic malignancies: historical perspective and practical applications. Semin Oncol 2009, 36:S2-S16.
38. Smith J.A., Glantz M. Statistical and trial design considerations in central nervous system prophylaxis studies. Semin Oncol 2009, 36:S69-S76.
39. van Besien K., Gisselbrecht C., Pfreundschuh M., Zucca E. Secondary lymphomas of the central nervous system: risk, prophylaxis and treatment. Leuk Lymphoma 2008, 49(Suppl 1):52-58.
40. Nagpal S., Glantz M.J., Recht L. Treatment and prevention of secondary CNS lymphoma. Semin Neurol 2010, 30:263-272.
41. Cheung C.W., Burton C., Smith P., Linch D.C., Hoskin P.J., Ardeshna K.M. Central nervous system chemoprophylaxis in non-Hodgkin lymphoma: current practice in the UK. Br J Haematol 2005, 131:193-200.
42. Abramson J.S., Hellmann M., Barnes J.A., Hammerman P., Toomey C., Takvorian T., et al. Intravenous methotrexate as central nervous system (CNS) prophylaxis is associated with a low risk of CNS recurrence in high-risk patients with diffuse large B-cell lymphoma. Cancer 2010, 116:4283-4290.
43. Tomita N., Kodama F., Kanamori H., Motomura S., Ishigatsubo Y. Prophylactic intrathecal methotrexate and hydrocortisone reduces central nervous system recurrence and improves survival in aggressive non-hodgkin lymphoma. Cancer 2002, 95:576-580.
44. Miyazaki K., Yamaguchi M., Suzuki R., Kobayashi Y., Maeshima A.M., Niitsu N., et al. CD5-positive diffuse large B-cell lymphoma: a retrospective study in 337 patients treated by chemotherapy with or without rituximab. Ann Oncol 2011, 22:1601-1607.
45. Cortes J., O'Brien S.M., Pierce S., Keating M.J., Freireich E.J., Kantarjian H.M. The value of high-dose systemic chemotherapy and intrathecal therapy for central nervous system prophylaxis in different risk groups of adult acute lymphoblastic leukemia. Blood 1995, 86:2091-2097.
46. Straus D.J., Wong G.Y., Liu J., Oppenberg J., Filippa D.A., Gold J.W., et al. Small non-cleaved-cell lymphoma (undifferentiated lymphoma, Burkitt's type) in American adults: results with treatment designed for acute lymphoblastic leukemia. Am J Med 1991, 90:328-337.
47. Mead G.M., Sydes M.R., Walewski J., Grigg A., Hatton C.S., Pescosta N., et al. An international evaluation of CODOX-M and CODOX-M alternating with IVAC in adult Burkitt's lymphoma: results of United Kingdom Lymphoma Group LY06 study. Ann Oncol 2002, 13:1264-1274.
48. Salzburg J., Burkhardt B., Zimmermann M., Wachowski O., Woessmann W., Oschlies I., et al. Prevalence, clinical pattern, and outcome of CNS involvement in childhood and adolescent non-Hodgkin's lymphoma differ by non-Hodgkin's lymphoma subtype: a Berlin-Frankfurt-Munster Group Report. J Clin Oncol 2007, 25:3915-3922.
49. Hoelzer D., Ludwig W.D., Thiel E., Gassmann W., Loffler H., Fonatsch C., et al. Improved outcome in adult B-cell acute lymphoblastic leukemia. Blood 1996, 87:495-508.
50. Schmitz N., Zeynalova S., Glass B., et al. CNS disease in younger patients (<=60years) with aggressive lymphoma treated in trials of the German High Grade Non Hodgkin Lymphoma Study Group (DSHNHL) and the MabThera International Trial (MInT). Program and abstracts of the 52nd American Society of Hematology Annual Meeting and Exposition Orlando, Florida 2010, Abstract 112.
51. Hegde U., Filie A., Little R.F., Janik J.E., Grant N., Steinberg S.M., et al. High incidence of occult leptomeningeal disease detected by flow cytometry in newly diagnosed aggressive B-cell lymphomas at risk for central nervous system involvement: the role of flow cytometry versus cytology. Blood 2005, 105:496-502.
52. Sancho J.M., Orfao A., Quijano S., Garcia O., Panizo C., Perez-Ceballos E., et al. Clinical significance of occult cerebrospinal fluid involvement assessed by flow cytometry in non-Hodgkin's lymphoma patients at high risk of central nervous system disease in the rituximab era. Eur J Haematol 2010, 85:321-328.
53. Quijano S., Lopez A., Manuel Sancho J., Panizo C., Deben G., Castilla C., et al. Identification of leptomeningeal disease in aggressive B-cell non-Hodgkin's lymphoma: improved sensitivity of flow cytometry. J Clin Oncol 2009, 27:1462-1469.
54. French C.A., Dorfman D.M., Shaheen G., Cibas E.S. Diagnosing lymphoproliferative disorders involving the cerebrospinal fluid: increased sensitivity using flow cytometric analysis. Diagn Cytopathol 2000, 23:369-374.
55. Stetler-Stevenson M. Flow cytometry in lymphoma diagnosis and prognosis: useful?. Best Pract Res Clin Haematol 2003, 16:583-597.
56. Siegal T., Zylber-Katz E. Strategies for increasing drug delivery to the brain: focus on brain lymphoma. Clin Pharmacokinet 2002, 41:171-186.
57. Glantz M.J., Van Horn A., Fisher R., Chamberlain M.C. Route of intracerebrospinal fluid chemotherapy administration and efficacy of therapy in neoplastic meningitis. Cancer 2010, 116:1947-1952.
58. Siegal T. Toxicity of treatment for neoplastic meningitis. Curr Oncol Rep 2003, 5:41-49.
59. Goekbuget N., Hartog C.M., Bassan R., Derigs H.G., Dombret H., Greil R., et al. Liposomal cytarabine is effective and tolerable in the treatment of CNS relapse of acute lymphoblastic leukemia (ALL) and very aggressive lymphoma. Haematologica 2011, 96:238-244.
60. Ostermann K., Pels H., Kowoll A., Kuhnhenn J., Schlegel U. Neurologic complications after intrathecal liposomal cytarabine in combination with systemic polychemotherapy in primary CNS lymphoma. J Neurooncol 2011, 103:635-640.
61. Brunn A., Montesinos-Rongen M., Strack A., Reifenberger G., Mawrin C., Schaller C., et al. Expression pattern and cellular sources of chemokines in primary central nervous system lymphoma. Acta Neuropathol 2007, 114:271-276.
62. Jahnke K., Coupland S.E., Na I.K., Loddenkemper C., Keilholz U., Korfel A., et al. Expression of the chemokine receptors CXCR4, CXCR5, and CCR7 in primary central nervous system lymphoma. Blood 2005, 106:384-385.
63. Falkenhagen K.M., Braziel R.M., Fraunfelder F.W., Smith J.R. B-cells in ocular adnexal lymphoproliferative lesions express B-cell attracting chemokine 1 (CXCL13). Am J Ophthalmol 2005, 140:335-337.
64. Mori M., Manuelli C., Pimpinelli N., Bianchi B., Orlando C., Mavilia C., et al. BCA-1, a B-cell chemoattractant signal, is constantly expressed in cutaneous lymphoproliferative B-cell disorders. Eur J Cancer 2003, 39:1625-1631.
65. Lopez-Giral S., Quintana N.E., Cabrerizo M., Alfonso-Perez M., Sala-Valdes M., De Soria V.G., et al. Chemokine receptors that mediate B cell homing to secondary lymphoid tissues are highly expressed in B cell chronic lymphocytic leukemia and non-Hodgkin lymphomas with widespread nodular dissemination. J Leukoc Biol 2004, 76:462-471.
66. Trentin L., Cabrelle A., Facco M., Carollo D., Miorin M., Tosoni A., et al. Homeostatic chemokines drive migration of malignant B cells in patients with non-Hodgkin lymphomas. Blood 2004, 104:502-508.
67. Zhou Y., Larsen P.H., Hao C., Yong V.W. CXCR4 is a major chemokine receptor on glioma cells and mediates their survival. J Biol Chem 2002, 277:49481-49487.
68. Venetz D., Ponzoni M., Schiraldi M., Ferreri A.J., Bertoni F., Doglioni C., et al. Perivascular expression of CXCL9 and CXCL12 in primary central nervous system lymphoma: T-cell infiltration and positioning of malignant B cells. Int J Cancer 2010, 127:2300-2312.
69. Fischer L., Korfel A., Pfeiffer S., Kiewe P., Volk H.D., Cakiroglu H., et al. CXCL13 and CXCL12 in central nervous system lymphoma patients. Clin Cancer Res 2009, 15:5968-5973.
70. Kryczek I., Wei S., Keller E., Liu R., Zou W. Stroma-derived factor (SDF-1/CXCL12) and human tumor pathogenesis. Am J Physiol Cell Physiol 2007, 292:C987-C995.
71. Booman M., Douwes J., Legdeur M.C., van Baarlen J., Schuuring E., Kluin P. From brain to testis: immune escape and clonal selection in a B cell lymphoma with selective outgrowth in two immune sanctuaries [correction of sanctuariesy]. Haematologica 2007, 92:e69-e71.
72. Cahill D.P., Levine K.K., Betensky R.A., Codd P.J., Romany C.A., Reavie L.B., et al. Loss of the mismatch repair protein MSH6 in human glioblastomas is associated with tumor progression during temozolomide treatment. Clin Cancer Res 2007, 13:2038-2045.
73. Lossos A., Ashhab Y., Sverdlin E., Amir G., Ben-Yehuda D., Siegal T. Late-delayed cerebral involvement in systemic non-Hodgkin lymphoma: a second primary tumor or a tardy recurrence?. Cancer 2004, 101:1843-1849.
74. McCann K.J., Ashton-Key M., Smith K., Stevenson F.K., Ottensmeier C.H. Primary central nervous system lymphoma: tumor-related clones exist in the blood and bone marrow with evidence for separate development. Blood 2009, 113:4677-4680.
75. Zelenetz A.D., Abramson J.S., Advani R.H., Andreadis C.B., Byrd J.C., Czuczman M.S., et al. NCCN Clinical Practice Guidelines in Oncology: non-Hodgkin's lymphomas. J Natl Compr Canc Netw 2010, 8:288-334.
76. Schroers R., Baraniskin A., Heute C., Vorgerd M., Brunn A., Kuhnhenn J., et al. Diagnosis of leptomeningeal disease in diffuse large B-cell lymphomas of the central nervous system by flow cytometry and cytopathology. Eur J Haematol 2010, 85:520-528.
77. Enting R.H. Leptomeningeal neoplasia: epidemiology, clinical presentation, CSF analysis and diagnostic imaging. Cancer Treat Res 2005, 125:17-30.
78. Jahnke K., Thiel E. Treatment options for central nervous system lymphomas in immunocompetent patients. Expert Rev Neurother 2009, 9:1497-1509.
79. Joerger M., Huitema A.D., Krahenbuhl S., Schellens J.H., Cerny T., Reni M., et al. Methotrexate area under the curve is an important outcome predictor in patients with primary CNS lymphoma: a pharmacokinetic-pharmacodynamic analysis from the IELSG no. 20 trial. Br J Cancer 2010, 102:673-677.
80. Adde M., Enblad G., Hagberg H., Sundstrom C., Laurell A. Outcome for young high-risk aggressive B-cell lymphoma patients treated with CHOEP-14 and rituximab (R-CHOEP-14). Med Oncol 2006, 23:283-293.
81. Chua S.L., Seymour J.F., Streater J., Wolf M.M., Januszewicz E.H., Prince H.M. Intrathecal chemotherapy alone is inadequate central nervous system prophylaxis in patients with intermediate-grade non-Hodgkin's lymphoma. Leuk Lymphoma 2002, 43:1783-1788.
82. Young R.C., Howser D.M., Anderson T., Fisher R.I., Jaffe E., DeVita V.T. Central nervous system complications of non-Hodgkin's lymphoma. The potential role for prophylactic therapy. Am J Med 1979, 66:435-443.
83. Wolf M.M., Olver I.N., Ding J.C., Cooper I.A., Liew K.H., Madigan J.P. Non-Hodgkin's lymphoma involving the central nervous system. Aust N Z J Med 1985, 15:16-21.
84. Bashir R.M., Bierman P.J., Vose J.M., Weisenburger D.D., Armitage J.O. Central nervous system involvement in patients with diffuse aggressive non-Hodgkin's lymphoma. Am J Clin Oncol 1991, 14:478-482.
85. Keldsen N., Michalski W., Bentzen S.M., Hansen K.B., Thorling K. Risk factors for central nervous system involvement in non-Hodgkins-lymphoma-a multivariate analysis. Acta Oncol 1996, 35:703-708.
86. Tondini C., Ferreri A.J., Siracusano L., Valagussa P., Giardini R., Rampinelli I., et al. Diffuse large-cell lymphoma of the testis. J Clin Oncol 1999, 17:2854-2858.
87. Ribrag V., Bibeau F., El Weshi A., Frayfer J., Fadel C., Cebotaru C., et al. Primary breast lymphoma: a report of 20 cases. Br J Haematol 2001, 115:253-256.
88. Wong W.W., Schild S.E., Halyard M.Y., Schomberg P.J. Primary non-Hodgkin lymphoma of the breast: the Mayo Clinic experience. J Surg Oncol 2002, 80:19-25. discussion 6.
89. Park B.B., Kim J.G., Sohn S.K., Kang H.J., Lee S.S., Eom H.S., et al. Consideration of aggressive therapeutic strategies for primary testicular lymphoma. Am J Hematol 2007, 82:840-845.