Blastic plasmacytoid dendritic cell neoplasm frequently shows occult central nervous system involvement at diagnosis and benefits from intrathecal therapy

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare aggressive myeloid neoplasm which shows a high rate of central nervous system (CNS) recurrence and overall survival (OS) of <1 year. Despite this, screening for CNS involvement is not routinely performed at diagnosis and intrathecal (IT) prophylaxis is not regularly administered in BPDCN. Here, we prospectively evaluated 13 consecutive BPDCN patients for the presence of CNS involvement by flow cytometry. Despite none of the patients presented with neurological symptoms, occult CNS involvement was detected in 6/10 cases evaluated at diagnosis and 3/3 studied at relapse/progression. BPDCN patients evaluated at diagnosis received IT treatment -either CNS prophylaxis (n = 4) or active therapy (n = 6)- and all but one remain alive (median follow-up of 20 months). In contrast, all three patients assessed at relapse/progression died. The potential benefit of IT treatment administered early at diagnosis on OS and CNS recurrence-free survival of BPDCN was further confirmed in a retrospective cohort of another 23 BPDCN patients. Our results show that BPDCN patients studied at diagnosis frequently display occult CNS involvement; moreover, they also indicate that treatment of occult CNS disease might lead to a dramatically improved outcome of BPDCN.

Medienart:

E-Artikel

Erscheinungsjahr:

2016

Erschienen:

2016

Enthalten in:

Zur Gesamtaufnahme - volume:7

Enthalten in:

Oncotarget - 7(2016), 9 vom: 01. März, Seite 10174-81

Sprache:

Englisch

Beteiligte Personen:

Martín-Martín, Lourdes [VerfasserIn]
Almeida, Julia [VerfasserIn]
Pomares, Helena [VerfasserIn]
González-Barca, Eva [VerfasserIn]
Bravo, Pilar [VerfasserIn]
Giménez, Teresa [VerfasserIn]
Heras, Cecilia [VerfasserIn]
Queizán, José-Antonio [VerfasserIn]
Pérez-Ceballos, Elena [VerfasserIn]
Martínez, Violeta [VerfasserIn]
Alonso, Natalia [VerfasserIn]
Calvo, Carlota [VerfasserIn]
Álvarez, Rodolfo [VerfasserIn]
Caballero, María Dolores [VerfasserIn]
Orfao, Alberto [VerfasserIn]

Links:

Volltext

Themen:

ALL therapy
Blastic plasmacytoid dendritic cell neoplasm
Central nervous system
Flow cytometry
Intrathecal prophylaxis
Journal Article
Research Support, Non-U.S. Gov't

Anmerkungen:

Date Completed 30.12.2016

Date Revised 13.11.2018

published: Print

Citation Status MEDLINE

doi:

10.18632/oncotarget.7101

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM257121862