@article{Wyndham H. Wilson_Jacoline E.C. Bromberg_Maryalice Stetler-Stevenson_Seth M. Steinberg_Lourdes Martin-Martin_Carmen Muñiz_Juan Manuel Sancho_Maria Dolores Caballero_Marjan A. Davidis_Rik A. Brooimans_Blanca Sanchez-Gonzalez_Antonio Salar_Eva González-Barca_Jose Maria Ribera_Margaret Shovlin_Armando Filie_Kieron Dunleavy_Thomas Mehrling_Michele Spina_Alberto Orfao_2014, place={Pavia, Italy}, title={Detection and outcome of occult leptomeningeal disease in diffuse large B-cell lymphoma and Burkitt lymphoma}, volume={99}, url={https://haematologica.org/article/view/7088}, DOI={10.3324/haematol.2013.101741}, abstractNote={The benefit of intrathecal therapy and systemic rituximab on the outcome of diffuse large B-cell lymphoma at risk of central nervous system disease is controversial. Furthermore, the effect of intrathecal treatment and rituximab in diffuse large B-cell and Burkitt lymphoma with occult leptomeningeal disease detected by flow cytometry at diagnosis is unknown. Untreated diffuse large B-cell (n=246) and Burkitt (n=80) lymphoma at clinical risk of central nervous system disease and having had pre-treatment cerebrospinal fluid were analyzed by flow cytometry and cytology. Spinal fluid involvement was detected by flow cytometry alone (occult) in 33 (13%) diffuse large B-cell and 9 (11%) Burkitt lymphoma patients, and detected by cytology in 11 (4.5%) and 5 (6%) patients, respectively. Diffuse large B-cell lymphoma with occult spinal fluid involvement had poorer survival (<em>P</em>=0.0001) and freedom from central nervous system relapse (<em>P</em><0.0001) compared to negative cases. Burkitt lymphoma with occult spinal fluid involvement had an inferior freedom from central nervous system relapse (<em>P</em>=0.026) but not survival. The amount of intrathecal chemotherapy was quantitatively associated with survival in diffuse large B-cell lymphoma with (<em>P</em>=0.02) and without (<em>P</em>=0.001) occult spinal fluid involvement. However, progression of systemic disease and not control of central nervous system disease was the principal cause of treatment failure. In diffuse large B-cell lymphoma, systemic rituximab was associated with improved freedom from central nervous system relapse (<em>P</em&gt;=0.003) but not with survival. Our results suggest that patients at risk of central nervous system disease should be evaluated by flow cytometry and that intrathecal prophylaxis/therapy is beneficial.}, number={7}, journal={Haematologica}, author={Wyndham H. Wilson and Jacoline E.C. Bromberg and Maryalice Stetler-Stevenson and Seth M. Steinberg and Lourdes Martin-Martin and Carmen Muñiz and Juan Manuel Sancho and Maria Dolores Caballero and Marjan A. Davidis and Rik A. Brooimans and Blanca Sanchez-Gonzalez and Antonio Salar and Eva González-Barca and Jose Maria Ribera and Margaret Shovlin and Armando Filie and Kieron Dunleavy and Thomas Mehrling and Michele Spina and Alberto Orfao}, year={2014}, month={Jul.}, pages={1228-1235} }