Hollender et al identified risk factors for central nervous system (CNS) involvement in patients with non-Hodgkin's lymphoma. These can help to identify a patient who should receive additional therapy to the central nervous system. The authors are from the Norwegian Radiation Hospital and Norwegian Medicines Agency in Oslo.

Patient selection: non-Hodgkin's lymphoma


Outcome: CNS recurrence


Conditions associated with CSN recurrence in the current study:

(1) Burkitt's lymphoma

(2) lymphoblastic lymphoma

(3) high-grade non-Hodgkin's lymphoma with >= 4 of 5 risk factors (see below)


Risk factors:

(1) age > 60 years (odds ratio 2.8)

(2) serum LDH >= 450 U/L (reference range not given; odds ratio 2.1)

(3) serum albumin < 35 g/L (odds ratio 2.5)

(4) retroperitoneal lymph node involvement (odds ratio 1.9)

(5) involvement of >= 2 extranodal sites (odds ratio 3.0)


The authors recommended CNS prophylaxis based on previous studies for involvement of:

(1) testes with Stage >= IIE

(2) paranasal sinuses)


The risk of CNS recurrence in low-grade non-Hodgkin's lymphoma was too low to recommend CNS prophylaxis.

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