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Kasenda B, Ferreri AJM, Marturano E, Forst D, Bromberg J, Ghesquieres H, Ferlay C, Blay JY, Hoang-Xuan K, Pulczynski EJ, Fosså A, Okoshi Y, Chiba S, Fritsch K, Omuro A, O'Neill BP, Bairey O, Schandelmaier S, Gloy V, Bhatnagar N, Haug S, Rahner S, Batchelor TT, Illerhaus G, Briel M. First-line treatment and outcome of elderly patients with primary central nervous system lymphoma (PCNSL)--a systematic review and individual patient data meta-analysis. Ann Oncol 2015; 26:1305-13. [PMID: 25701456 DOI: 10.1093/annonc/mdv076] [Citation(s) in RCA: 121] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Accepted: 02/10/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND To investigate prognosis and effects of first-line therapy in elderly primary central nervous system lymphoma (PCNSL) patients. PATIENTS AND METHODS A systematic review of studies about first-line therapy in immunocompetent patients ≥60 years with PCNSL until 2014 and a meta-analysis of individual patient data from eligible studies and international collaborators were carried out. RESULTS We identified 20 eligible studies; from 13 studies, we obtained individual data of 405 patients, which were pooled with data of 378 additional patients (N = 783). Median age and Karnofsky Performance Score (KPS) was 68 years (range: 60-90 years) and 60% (range: 10%-100%), respectively. Treatments varied greatly, 573 (73%) patients received high-dose methotrexate (HD-MTX)-based therapy. A total of 276 patients received whole-brain radiotherapy (median 36 Gy, range 28.5-70 Gy). KPS ≥ 70% was the strongest prognostic factor for mortality [hazard ratio (HR) 0.50, 95% confidence interval (CI) 0.41-0.62]. After a median follow-up of 40 months, HD-MTX-based therapy was associated with improved survival (HR 0.70, 95% CI 0.53-0.93). There was no difference between HD-MTX plus oral chemotherapy and more aggressive HD-MTX-based therapies (HR 1.39, 95% CI 0.90-2.15). Radiotherapy was associated with an improved survival, but correlated with an increased risk for neurological side-effects (odds ratio 5.23, 95% CI 2.33-11.74). CONCLUSIONS Elderly PCNSL patients benefit from HD-MTX-based therapy, especially if combined with oral alkylating agents. More aggressive HD-MTX protocols do not seem to improve outcome. WBRT may improve outcome, but is associated with increased risk for neurological side-effects. Prospective trials for elderly PCNSL patients are warranted.
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Affiliation(s)
- B Kasenda
- Department of Oncology, University Hospital of Basel, Basel Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland
| | - A J M Ferreri
- Unit of Lymphoid Malignancies, Department of Onco-Hematology, San Raffaele Scientific Institute, Milan, Italy
| | - E Marturano
- Unit of Lymphoid Malignancies, Department of Onco-Hematology, San Raffaele Scientific Institute, Milan, Italy
| | - D Forst
- Partners Neurology Residency Program, Harvard Medical School, Boston, USA
| | - J Bromberg
- Department of Neuro-Oncology, Daniel den Hoed Cancer Center, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - H Ghesquieres
- Department of Hematology, Centre Léon Bérard, University of Lyon, Lyon
| | - C Ferlay
- Department of Hematology, Centre Léon Bérard, University of Lyon, Lyon
| | - J Y Blay
- Department of Hematology, Centre Léon Bérard, University of Lyon, Lyon
| | - K Hoang-Xuan
- Department of Neurology Mazarin, LOC National Expert Center, APHP, IHU, UPMC, CRICM, GH Pitié-Salpêtrière, Paris, France
| | - E J Pulczynski
- Department of Haematology, Nordic Lymphoma Group, University Hospital Aarhus, Aarhus, Denmark
| | - A Fosså
- Norwegian Department of Oncology, Nordic Lymphoma Group, Radium Hospital, Oslo, Norway
| | - Y Okoshi
- Faculty of Medicine, Department of Hematology, University of Tsukuba, Tsukuba, Japan
| | - S Chiba
- Faculty of Medicine, Department of Hematology, University of Tsukuba, Tsukuba, Japan
| | - K Fritsch
- Department of Hematology/Oncology, University Hospital Freiburg, Freiburg, Germany
| | - A Omuro
- Department of Neurology Mazarin, LOC National Expert Center, APHP, IHU, UPMC, CRICM, GH Pitié-Salpêtrière, Paris, France
| | - B P O'Neill
- Department of Neurology, Mayo Medical School, Rochester, USA
| | - O Bairey
- Institute of Hematology, Rabin Medical Center, Beilinson Hospital, Tel Aviv Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - S Schandelmaier
- Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland
| | - V Gloy
- Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland
| | - N Bhatnagar
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada
| | - S Haug
- Psychiatry and Psychotherapy, University Hospital Freiburg, Freiburg
| | - S Rahner
- Medical Faculty, University of Freiburg, Freiburg, Germany
| | - T T Batchelor
- Partners Neurology Residency Program, Harvard Medical School, Boston, USA Stephen E. and Catherine Pappas Center for Neuro-Oncology, Massachusetts General Hospital, Boston, USA
| | - G Illerhaus
- Stuttgart Cancer Center, Eva-Mayr-Stihl Tumor Center, Stuttgart, Germany
| | - M Briel
- Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada
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Walsh K, Codd V, Smirnov I, Rice T, Decker P, Hansen H, Molinaro A, Pekmezci M, Tihan T, Berger M, Chang S, Prados M, Lachance D, O'Neill BP, van der Harst P, Wiencke J, Samani N, Jenkins R, Wrensch M. ED-36 * INHERITED VARIANTS NEAR TERC AND TERT ARE ASSOCIATED WITH LONGER TELOMERES AND INCREASED GLIOMA RISK: GENOME-WIDE ASSOCIATION RESULTS FROM THE UCSF ADULT GLIOMA STUDY AND THE ENGAGE CONSORTIUM TELOMERE GROUP. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou253.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Patrick O'Neill B, Braggio E, O'Neill BP, Van Wier S, Ojha J, McPhail E, Asmann Y, Egan J, Ayres da Silva J, Schiff D, Lopes MB, Valdez R, Tibes R, Eckloff B, Stewart AK, Fonseca R. GENOME-WIDE ANALYSIS UNCOVERS RECURRENT ALTERATIONS IN PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMAS (PCNSL). Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou209.7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Walsh KM, Walsh KM, Codd V, Smirnov IV, Rice T, Decker PA, Hansen HM, Kollmeyer T, Kosel ML, Molinaro AM, McCoy LS, Bracci PM, Cabriga BS, Pekmezci M, Zheng S, Wiemels JL, Pico AR, Tihan T, Berger MS, Chang SM, Prados MD, Lachance DH, O'Neill BP, Sicotte H, Eckel-Passow JE, van der Harst P, Wiencke JK, Samani NJ, Jenkins RB, Wrensch MR. TELOMERE LENGTH VARIANTS ARE ASSOCIATED WITH HIGH-GRADE GLIOMA RISK: IDENTIFICATION OF A NOVEL GLIOMA RISK LOCUS BY GENOME-WIDE ASSOCIATION STUDY. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou206.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Bie L, Li Y, Yuan H, Bondy M, Bainbridge M, Jhangiani S, Jalali A, Plon SE, Armstrong G, Bernstein J, Claus E, Davis F, Houlston R, Il'yasova D, Jenkins R, Johansen C, Lachance D, Lai R, Lau C, Merrell R, Olson S, Sadetzki S, Schildkraut J, Shete S, Barnholtz-Sloan J, Wrensch M, Consortium TG, Melin B, Gibbs RA, Haberler C, Czech T, Chocholous M, Dorfer C, Slavc I, Hayashi S, Sasaki H, Kimura T, Nakamura T, Miwa T, Hirose Y, Yoshida K, Jalali A, Bainbridge M, Jhangiani S, Plon SE, Armstrong G, Bernstein J, Claus E, Davis F, Houlston R, Il'yasova D, Jenkins R, Johansen C, Lachance D, Lai R, Lau C, Merrell R, Olson SH, Sadetzki S, Schildkraut J, Shete S, Barnholtz-Sloan J, Wrensch M, Melin B, Gibbs RA, Bondy M, Jenkins R, Wrensch M, Kollmeyer T, Armstrong G, Olson S, Lai R, Lachance D, Lau C, Claus E, Barnholtz-Sloan J, Il'yasova D, Schildkraut J, Houlston R, Shete S, Bernstein J, Davis F, Merrell R, Johansen C, Sadetzki S, Consortium TG, Melin B, Bondy M, Palmer J, Li J, Kenyon L, Andrews D, Kim L, Glass J, Werner-Wasik M, Shi W, Takayanagi S, Mukasa A, Aihara K, Saito K, Otani R, Tanaka S, Nakatomi H, Aburatani H, Ichimura K, Ueki K, Saito N, Walsh KM, Decker PA, Eckel-Passow JE, Molinaro AM, Hansen HM, Rice T, Zheng S, Kollmeyer T, Berger MS, Chang SM, Prados MD, Rynearson A, Caron A, Kosel ML, Lachance DH, O'Neill BP, Giannini C, Wiencke JK, Jenkins RB, Wrensch MR, Wang Z, Bao Z, Jiang T, Wang Z, Bao Z, Jiang T. MOLECULAR EPIDEMIOLGOY. Neuro Oncol 2013. [DOI: 10.1093/neuonc/not180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bie L, Zhao G, McClland M, Ju Y, Li PY, Zhou DJ, Jin Z, Bie L, Jenkins RB, Xiao Y, Sicotte H, Decker PA, Kollmeyer TM, Hansen HM, Kosel ML, Zheng S, Walsh KM, Rice T, Bracci P, Smirnov I, Patoka JF, Hsuang G, Wiemels JL, Tehan T, Pico AR, Prados MD, Berger MS, Caron AA, Fink SR, Halder C, Rynearson AL, Fridley BL, O'Neill BP, Giannini C, Lachance DH, Wienke JK, Eckel-Passow JE, Wrensch MR, Aref D, Perry A, Taylor M, Eberhardt C, Olson J, Moffatt C, Croul S, Maurice C, Belanger K, Berthelet F, Weng X, Amirian ES, Liu Y, Okada H, Sarkar SN, Bondy ML, Scheurer ME, Verhaak R, Liu Y, Amirian ES, Okada H, Sarkar S, Scheurer M, Bondy M, Liu Y, Melin B, Wang Z, Rajaraman P, Chanock S, Bondy M, Consortium G, Smith A, Accomando WP, Houseman EA, Marsit CJ, Weincke JK, Kelsey KT. LAB-MOLECULAR EPIDEMIOLOGY. Neuro Oncol 2012. [DOI: 10.1093/neuonc/nos225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Jensen RL, Abraham S, Hu N, Jensen RL, Boulay JL, Leu S, Frank S, Vassella E, Vajtai I, von Felten S, Taylor E, Schulz M, Hutter G, Sailer M, Hench J, Mariani L, van Thuijl HF, Scheinin I, van Essen DF, Heimans JJ, Wesseling P, Ylstra B, Reijneveld JC, Borges AR, Larrubia PL, Marques JMB, Cerdan SG, Brastianos P, Horowitz P, Santagata S, Jones RT, McKenna A, Getz G, Ligon K, Palescandolo E, Van Hummelen P, Stemmer-Rachamimov A, Louis D, Hahn WC, Dunn I, Beroukhim R, Guan X, Vengoechea J, Zheng S, Sloan A, Chen Y, Brat D, O'Neill BP, Cohen M, Aldape K, Rosenfeld S, Noushmehr H, Verhaak RG, Barnholtz-Sloan J, Bahassi EM, Li YQ, Cross E, Li W, Vijg J, McPherson C, Warnick R, Stambrook P, Rixe O, Manterola L, Tejada-Solis S, Diez-Valle R, Gonzalez M, Jauregui P, Sampron N, Barrena C, Ruiz I, Gallego J, Delattre JY, de Munain AL, Mlonso MM, Saito K, Mukasa A, Nagae G, Aihara K, Takayanagi S, Aburatani H, Saito N, Kong XT, Fu BD, Du S, Hasso AN, Linskey ME, Bota D, Li C, Chen YS, Chen ZP, Kim CH, Cheong JH, Kim JM, Yelon NP, Jacoby E, Cohen ZR, Ishida J, Kurozumi K, Ichikawa T, Onishi M, Fujii K, Shimazu Y, Date I, Narayanan R, Ho QH, Levin BS, Maeder ML, Joung JK, Nutt CL, Louis DN, Thorsteinsdottir J, Fu P, Gehrmann M, Multhoff G, Tonn JC, Schichor C, Thirumoorthy K, Gordon N, Walston S, Patel D, Okamoto M, Chakravarti A, Palanichamy K, French P, Erdem L, Gravendeel L, de Rooi J, Eilers P, Idbaih A, Spliet W, den Dunnen W, Teepen J, Wesseling P, Smitt PS, Kros JM, Gorlia T, van den Bent M, McCarthy D, Cook RW, Oelschlager K, Maetzold D, Hanna M, Wick W, Meisner C, Hentschel B, Platten M, Sabel MC, Koeppen S, Ketter R, Weiler M, Tabatabai G, Schilling A, von Deimling A, Gramatzki D, Westphal M, Schackert G, Loeffler M, Simon M, Reifenberger G, Weller M, Moren L, Johansson M, Bergenheim T, Antti H, Sulman EP, Goodman LD, Wani KM, DeMonte F, Aldape KD, Krischek B, Gugel I, Aref D, Marshall C, Croul S, Zadeh G, Nilsson CL, Sulman E, Liu H, Wild C, Lichti CF, Emmett MR, Lang FF, Conrad C, Alentorn A, Marie Y, Boisselier B, Carpetier C, Mokhtari K, Hoang-Xuan K, Capelle L, Delattre JY, Idbaih A, Lautenschlaeger T, Huebner A, McIntyre JB, Magliocco T, Chakravarti A, Hamilton M, Easaw J, Pollo B, Calatozzolo C, Vuono R, Guzzetti S, Eoli M, Silvani A, Di Meco F, Filippini G, Finocchiaro G, Joy A, Ramesh A, Smirnov I, Reiser M, Shapiro W, Mills G, Kim S, Feuerstein B, Gonda DD, Li J, McCabe N, Walker S, Goffard N, Wikstrom K, McLean E, Greenan C, Delaney T, McCarthy M, McDyer F, Keating KE, James IF, Harrison T, Mullan P, Harkin DP, Carter BS, Kennedy RD, Chen CC, Patel AS, Allen JE, Dicker DT, Rizzo K, Sheehan JM, Glantz MJ, El-Deiry WS, Salhia B, Ross JT, Kiefer J, Van Cott C, Metpally R, Baker A, Sibenaller Z, Nasser S, Ryken T, Ramanathan R, Berens ME, Carpten J, Tran NL, Bi Y, Pal S, Zhang Z, Gupta R, Macyszyn L, Fetting H, O'Rourke D, Davuluri RV, Ezrin AM, Moore K, Stummer W, Hadjipanayis CG, Cahill DP, Beiko J, Suki D, Prabhu S, Weinberg J, Lang F, Sawaya R, Rao G, McCutcheon I, Barker FG, Aldape KD, Trister AD, Bot B, Fontes K, Bridge C, Baldock AL, Rockhill JK, Mrugala MM, Rockne RR, Huang E, Swanson KR, Underhill HR, Zhang J, Shi M, Lin X, Mikheev A, Rostomily RC, Scheck AC, Stafford P, Hughes A, Cichacz Z, Coons SW, Johnston SA, Mainwaring L, Horowitz P, Craig J, Garcia D, Bergthold G, Burns M, Rich B, Ramkissoon S, Santagata S, Eberhart C, Ligon A, Goumnerova L, Stiles C, Kieran M, Hahn W, Beroukhim R, Ligon K, Ramkissoon S, Olausson KH, Correia J, Gafni E, Liu H, Theisen M, Craig J, Hayashi M, Haidar S, Maire C, Mainwaring LA, Burns M, Norden A, Wen P, Stiles C, Ligon A, Kung A, Alexander B, Tonellato P, Ligon KL. LAB-OMICS AND PROGNOSTIC MARKERS. Neuro Oncol 2012. [DOI: 10.1093/neuonc/nos231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Khan RB, Hudson MM, Brannon Morris E, Ledet D, Pui CH, Scott H, Browne E, Crom D, Hinds P, Zhu L, Kumar S, Ness KK, Rogers LR, Ostrom Q, Vengoechea J, Chen Y, Davitkov P, Strodtbeck K, Selman WR, Gerson S, Nock C, Machtay M, Lo S, Sloan AE, Barnholtz-Sloan J, Johnson DR, Decker PA, Hanson AC, Hammack JE, Amirian ES, Goodman JC, New P, Scheurer ME, Kruchko C, Dolecek TA, McCarthy BJ, Mulpur BH, Nabors LB, Egan KM, Browning JE, Olson JJ, Thompson RC, Madden MH, Lupo PJ, Cai Y, Nousome D, Scheurer ME, O'Neill BP, Decker PA, Cerhan JR, Villano JL, Moirangthem V, Pittman T, Durbin EB, Campen CJ, Von Behren J, Reynolds P, Fisher PG, Merker VL, Slattery WH, Muzikansky A, Barker FG, Plotkin SR, Rotman LE, Ostrom Q, Vengoechea J, Kuhns B, Rogers L, Sloan A, Barnholtz-Sloan J, Mrugala MM, Wen PY, Rogers LR, Sonabend AM, Zacharia BE, Goldstein H, Bruce S, Bruce JN, Kim T, Chiang VL, Yu JB. CLIN-EPIDEMIOLOGY. Neuro Oncol 2012. [DOI: 10.1093/neuonc/nos221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Roth P, Silginer M, Goodman SL, Hasenbach K, Thies S, Schraml P, Tabatabai G, Moch H, Tritschler I, Weller M, Perin A, Verginelli F, Dali R, Hei Man Fung K, Lo R, Longatti P, Guiot M, Del Maestro RF, Rossi S, Di Porzio U, Stechishin O, Weiss S, Stifani S, Sanzey M, Golebiewska A, Stieber D, Nazarov P, Muller A, Vallar L, Niclou SP, Lawler SE, Chiocca E, Williams SP, Wanka C, Steinbach JP, Rieger J, Lavon I, Zrihan D, Refael M, Siegal T, Sminia P, Van Nifterik KA, Van den Berg J, Lafleur VM, Stalpers LJA, Slotman BJ, Di stefano A, Enciso-Mora V, Marie Y, Desestret V, Labussiere M, Idbaih A, Hoang-Xuan K, Delattre J, Houlston R, Sanson M, Woehrer A, Slavc I, Stefanits H, Waldhoer T, Heinzl H, Zielonke N, Czech T, Hainfellner JA, Haberler C, Zouaoui S, Darlix A, Virion J, Rigau V, Mathieu-Daude H, Bauchet F, Figarella-Branger D, Duffau H, Taillandier L, Bauchet L, Naydenov E, Popov R, Tanova R, Minkin K, De Vleeschouwer S, Van Gool S, Cavaletti G, Wilbers J, Hoebers F, Boogerd W, van Werkhoven E, Nowee M, Hart G, van Dijk E, Kappelle A, Dorresteijn L, Furuse M, Miyata T, Yoritsune E, Kawabata S, Kuroiwa T, Miyatake S, Boele FW, Heimans JJ, Aaronson NK, Peereboom DM, Sloan AE, Supko JG, Ye X, Rich JN, Prados MD, Ahluwalia M, Grossman SA, Spiegl-Kreinecker S, Loetsch D, Taphoorn MJB, Wild M, Ghanim B, Pirker C, Pichler J, Serge W, Lenz S, Wurm G, Berger W, Tamiya T, Miyake K, Postma TJ, Okada M, Kawai N, Grossi I, Rigakos G, Lampropoulos S, Stavridi F, Tsoulos N, Nasioulas G, Papadopoulou E, Razis E, Reijneveld JC, Schroeteler J, Klosterkemper Y, Schwake M, Stummer W, Ewelt C, Field KM, Rosenthal MA, Wheeler H, Cher L, Hovey E, Klein M, Nowak AK, Brown C, Livingstone A, Sawkins K, Simes J, Linsenmann T, Jawork A, Hagemann C, Kessler AF, Berg F, Habets EJJ, Lohr M, Ernestus RI, Vince GH, Rodriguez FJ, Heaphy CM, Nguyen DN, de Wilde RF, Orr B, Raabe E, Eberhart CG, Taphoorn MJB, Meeker AK, Klein SP, Van Calenbergh F, van Loon J, Menten J, Clement P, De Vleeschouwer S, Goffin J, Lonardi F, Gioga G, Nederend S, Bonometti M, Ferigo L, Buonocore F, Campostrini F, Golebiewska A, Bougnaud S, Stieber D, Brons N, Vallar L, Hertel F, Klein M, Bjerkvig R, Niclou S, Strik HM, Carl B, Kallenberg K, Moiyadi AV, Gupta T, Shetty P, Nair V, Jalali R, Delgadillo D, Compter I, de Kunder SL, Houben RMA, Jager JJ, Bosmans G, Anten MHME, Baumert BG, Duerinck J, Du Four S, Van Binst A, Xuan KH, Everaert H, Michotte A, D'haens J, Neyns B, Basmaci M, Hasturk AE, de Kunder SL, Compter I, Schijns OEMG, ter Laak-Poort MP, Bottomley A, Anten MHME, Jansen RLH, Baumert BG, Happold C, Roth P, Wick W, Schmidt N, Florea A, Reifenberger G, Weller M, Van den Bent MJ, Ho C, Leugner D, Easaw J, Lim G, Rosenberg T, Thomassen M, Jensen S, Larsen M, Sorensen K, Hermansen S, Reijneveld JC, Kruse T, Kristensen B, Pichler J, Hollmuller I, Ghanim B, Spiegl-Kreinecker S, Ursu R, Ferrari D, Bailon O, Augier A, Minaya Flores P, Dubessy A, Banissi C, Belin C, Levy C, Carpentier AF, Boudouresque F, Delphino C, Metellus P, Pirisi V, Figarella-Branger D, Chinot O, Ouafik L, Berthois Y, Nakamura H, Makino K, Hide T, Yano S, Kuratsu J, Stevens GHJ, Ahluwalia M, Hashemi N, Berbis J, Peereboom D, Barnett GH, Wibom C, Ghasimi S, Van Loo P, Brannstrom T, Trygg J, Henriksson R, Bergenheim T, Andersson U, Auquier P, Ryden P, Melin B, Ackerl MS, Flechl B, Dieckmann K, Preusser M, Widhalm G, Sax C, Marosi C, Seliger C, Kumthekar PU, Leukel P, Jachnik B, Bogdahn U, Vollmann A, Hau P, Chung SA, Luk PP, Shen H, Decollogne S, Day BW, Grimm SA, Stringer BW, Hogg PJ, Dilda PJ, McDonald KL, Cernea DR, Pruteanu P, Todor N, Florian S, Bogdan V, Cercea C, Chandler J, Leibetseder A, Ackerl M, Flechl B, Sax C, Widhalm G, Dieckmann K, Preusser M, Marosi C, Torres-Martin M, Pena-Granero C, Helenowski IB, Isla A, Pinto GR, Custodio AC, Melendez B, Castresana JS, Rey JA, Banissi C, Maubant S, Rancic M, Carpentier AF, Marymont M, Stancheva G, Goranova T, Laleva M, Kamenova M, Mitkova A, Velinov N, Kaneva R, Poptodorov G, Mitev V, Gabrovsky N, Rademaker A, Piccirillo SGM, Spiteri I, Sottoriva A, Marko N, Tavare' S, Collins P, Watts C, Fedrigo CA, Da Rocha AB, Stalpers LJA, Wagner L, Baumert BG, Slotman B, Peters GJ, Sminia P, Fernandez M, Gawrisch VJ, Ruttgers M, Jachnik B, Proescholdt M, Bogdahn U, Stell B, Vollmann-Zwerenz A, Hau P, Trevisan E, Magistrello M, Bertero L, Bosa C, Greco Crasto S, Garbossa D, Lolli I, Ruda R, Raizer J, Soffietti R, Ichikawa T, Kurozumi K, Onishi M, Ishida J, Shimazu Y, Fujii K, Inoue S, Chiocca EA, Kaur B, Kumthekar PU, Date I, Dictus C, Friauf S, Valous NA, Muerle B, Unterberg AW, Herold-Mende CC, Caroli M, Di Dristofori A, Lucarella F, Grimm S, Menghetti C, Lanfranchi G, Gaini SM, Duerinck J, Clement P, Bouttens F, Neyns B, D'Hondt L, Gennigens C, Staelens Y, Jacobs DI, Joosens E, Van Fraeyenhove F, Rogiers A, Darlix A, Baumann C, Lorgis V, Blonski M, Chauffert B, Zouaoui S, Beauchesne P, Stell BV, Taillandier L, Vaccaro V, Pace A, Vidiri A, Vari S, Telera S, Giannarelli D, Russillo M, Anelli V, Carapella CM, Rademaker A, Fabi A, Florian SI, Soritau O, Neagoe I, Abrudan C, Tomuleasa C, Cernea D, Petrescu M, Baritchii A, Florian SI, Chandler J, Abrudan C, Baritchii A, Fornara O, Mirza S, Khan Z, Odeberg J, Stragliotto G, Butler L, Soderberg-Naucler C, Soderberg Naucler C, Marymont MH, Stragliotto G, Peredo I, Rahbar A, Lilja A, Taher C, Orrego A, Wolmer Solberg N, Brandes AA, Depenni R, Marcello N, Helenowski IB, Valentini A, Faedi M, Urbini B, Crisi G, Franceschi E, Poggi R, Baruzzi A, Berghauser Pont LME, Kloezeman JJ, French PJ, Wagner L, Dirven CMF, Lamfers MLM, Leenstra SL, Stragliotto G, Bartek J, Hylin S, Peredo I, Rahbar A, Soderberg Naucler C, Dahlrot RH, Raizer JJ, Kristensen BW, Hjelmborg JVB, Herrstedt J, Hansen S, Nittby HC, Persson BRR, Ceberg C, Widegren B, Salford LG, Poulsen HS, Claudel G, Grunnet K, Michaelsen SR, Broholm H, Christensen IJ, Tinchon A, Oberndorfer S, Marosi C, Ruda R, Sax C, Calabek B, Muller C, Grisold W, Bouwens T, Trouw L, Heijsman D, Kremer A, van der Spek P, Dirven C, Lamfers M, Al-Khawaja H, Pollanz S, Colmar K, Tinchon A, Calabek B, Oberndorfer S, Pohnl R, Grisold W, Hong Y, Ko K, Lee E, De Groot M, Choenni EP, Garat E, Sizoo EM, Uitdehaag B, Buter J, Van Linde ME, Postma TJ, Taphoorn MJB, Heimans JJ, Reijneveld JC, Bertero L, Bosa C, Beauchesne P, Trevisan E, Tarenzi L, Garbossa D, Mantovani C, Soffietti R, Ruda R, Lotsch D, Spiegl-Kreinecker S, Pirker C, Hlavaty J, Hassani K, Petznek H, Grusch M, Berger W, Kaloshi G, Spahiu O, Djamandi P, Djamandi P, Ruka M, Haxhihyseni E, Bushati T, Bethune B, Petrela M, Tabatabai G, Felsberg J, Sabel M, Hofer S, Westphal M, Weller M, Reifenberger G, Wertz M, Padovani L, Nguyen-Thi P, Bequet-Boucard C, Barrie M, Matta M, Muracciole X, Chinot O, Timmer M, Rohn G, Goldbrunner R, Thon N, Kreth F, Di Patrizio P, Simon M, Westphal M, Schackert G, Nikkhah G, Tatagiba M, Hentschel B, Weller M, Tonn J, Smrdel U, Fack F, Taillandier L, Zheng L, Frezza C, Keunen O, Kalna G, Nazarov P, Gottlieb E, Niclou SP, Bjerkvig R, Radic J, Murgic J, Sizoo EM, Maric Brozic J, Jazvic M, Soldic Z, Bolanca A, Raizer J, Grimm S, Levy R, Muro K, Rosenow J, Chandler J, Taphoorn MJB, Bredel M, Kalita O, Vaverka M, Hrabalek L, Zlevorova M, Cechakova E, Trojanec R, Kneblova M, Hajduch M, Ehrmann J, Uitdehaag B, Naskhletashvili DR, Gorbounova V, Bychkov M, Bekyashev A, Karakhan V, Aloshin V, Fu R, Moskvina E, Gaziel TB, Poulsen HS, Heimans JJ, Muhic A, Rahbar A, Peredo I, Wolmer Solberg N, Taher C, Dzabic M, Xu X, Skarman P, Tammik C, Stragliotto G, Deliens L, Soderberg-Naucler C, Ahluwalia MS, hashemi-Sadraei N, Barnett GH, Fabbro M, Laigre M, Langlois C, Castan F, Bauchet L, Duffau H, Reijneveld JC, Bonafe A, Spoor JKH, Khorami K, Kloezeman J, Balvers R, Dirven C, Lamfers M, Leenstra S, Spoor JKH, van der Kaaij M, Pasman HW, Kloezeman J, Geurtjens M, Dirven C, Lamfers M, Leenstra S, Trister AD, Neal ML, Cloke T, Baldock AL, Ahn S, Rampling RP, Mrugala MM, Rockhill JK, Rockne R, Swanson KR, Swanson KR, Rockne R, Hawkins-Daarud A, Corwin D, Neal ML, Rockhill JK, James A, Mrugala MM, Rostomily R, Alvord EC, D'Alessandro G, Catalano M, Cipriani R, Chece G, Limatola C, Graham K, Williamson A, Mulholland P, Lamb C, James A, Clark B, Chalmers A, de Kunder SL, Postma AA, Huysentruyt CJR, Dings J, ter Laak-Poort MP, Seystahl K, Peoples S, Wiestler B, Hundsberger T, Happold C, Wick W, Weller M, Wick A, Janz C, Buhl RM, Jiang T, Darlix A, Al-Salihi O, Virion J, Zouaoui S, Rigau V, Tretarre B, Mandonnet E, Pinelli C, Duffau H, Taillandier L, Bauchet L, Ng H, Twelves C, Yang L, Pang JCS, Roelcke U, Nowosielski M, Bertero L, Crippa F, Hofer S, Bruehlmeier M, Remonda L, Soffietti R, Halford S, Wyss M, Reyes-Botero G, Fiorelli M, Mokhtari K, Delattre J, Laigle-Donadey F, Amelio D, Lorentini S, Giri MG, Meliado G, McGuigan L, Fellin F, Gargano G, Ricciardi GK, Pioli F, Schwarz M, Amichetti M, Ribba B, Kaloshi G, Peyre M, Ricard D, Ritchie J, Tod M, Cartalat-Carel S, Delattre J, Honnorat J, Grenier E, Ducray F, Bastin F, Pirotte B, Bouquey D, Roger T, Sing-Jasuja H, Riva M, Raneri F, Pessina F, Casarotti A, Comi A, Fava E, Papagno C, Bello L, Blonski M, Pallud J, Schumacher T, Goze C, Mandonnet E, Beauchesne P, Baron M, Fontaine D, Darlix A, Duffau H, Taillandier L, Sinclair G, Hylin S, Sahm F, Nordstrom L, Stragliotto G, Mucha-Malecka A, Glinski B, Malecki K, Ahluwalia MS, Robles Irizarry L, Hashemi Sadraei N, Stevens G, Barnett GH, von Deimling A, Mucha-Malecka A, Glinski B, Malecki K, Jarosz M, Dymek P, Chrostowska A, Hetnal M, Miwa T, Oi S, Nonaka Y, Wick W, Sasaki H, Adachi J, Suzuki T, Yanagisawa T, Mishima K, Fukuoka K, Koga T, Matsutani M, Nishikawa R, Burger MC, Platten M, Brucker DP, Baumgarten P, Ronellenfitsch MW, Hasselblatt M, Eccles MR, Klingebiel T, Weller M, Mittelbronn M, Steinbach JP, Walker DA, Ardon H, Collier J, Kennedy C, Grundy R, Wilne S, Lakhanpaul M, Baker M, Trusler J, Linsell S, Dudley J, Kieffer V, Ewelt C, Dellatolas G, Chevignard M, Puget S, Dhermain F, Grill J, Dufour C, Messina R, Zambuto M, Calace A, De Tommasi A, Gunes D, Malova JV, Peyrl A, Sauermann R, Chocholous M, Azizi AA, Prucker C, Jaeger W, Hoeferl M, Slavc I, Pollo B, Wolfer J, Maderna E, Vuono R, Farinotti M, Massimino M, Finocchiaro G, Valentini L, Aurtenetxe O, Urberuaga A, Lopez J, Gaafar A, De Vleeschouwer S, Navajas A, Perez Bovet J, Kusak M, Martinez Moreno N, Gutierrez Sarraga J, Rey Portoles G, Martinez Alvarez R, Yachi K, Kurihara J, Fukushima T, Stummer W, Watanabe T, Yoshino A, Katayama Y, Nishimoto H, Ghasimi S, Haapasalo H, Eray M, Korhonen K, Brannstrom T, Hedman H, Wick W, Andersson U, Miyatake S, Kawabata S, Hiramatsu R, Hirota Y, Kuroiwa T, Ono K, Sugio H, Ito T, Ozaki Y, Meisner C, Sato K, Oikawa M, Daniel R, Tuleasca C, Negretti L, Magaddino V, Levivier M, Pfister C, Pfrommer H, Tatagiba MS, Hentschel B, Roser F, Linsler S, Reuss D, Urbschat S, Klotz M, Ketter R, Oertel J, Ketter R, Linsler S, Kramer D, Platten M, Driess C, Lerner C, Oertel J, Urbschat S, Williamson A, Smith S, Clark B, Chalmers A, James A, Saini SS, Sabel M, Hall G, Davis C, Jang W, Jung S, Jung T, Moon K, Kim I, Carrabba G, Conte V, Riva M, Koeppen S, Caroli M, Artoni A, Martinelli I, Gaini SM, Martinez Moreno NE, Kusak ME, Gutierrez Sarraga J, Rey Portoles G, Martinez Alvarez R, Megyesi JF, Ketter R, Macdonald D, Chaudhary N, Weber DC, Li J, Miller R, Villa S, Anacak Y, Poortmans P, Baumert B, Pica A, Simon M, Ozyigit G, Preusser M, Torres-Martin M, Lassaletta L, Pena-Granero C, de Campos JM, Gutierrez M, Castresana JS, Rey JA, Suki D, Reifenberger G, Sivaganean A, Rao G, Rhines LD, Caffo M, Barresi V, Cacciola F, Giugno A, Passalacqua M, Alafaci C, Caruso G, Weller M, Tomasello F, Widhalm G, Kiesel B, Novak K, Wohrer A, Matula C, Prayer D, Marosi C, Preusser M, Knosp E, Gallego Perez-Larraya J, Wolfsberger S, De Campos JM, Kusak ME, Aguirre DT, Ordonez C, Fortes J, Chamberlain MC, Ellithy MAM, Ghali RR, Abdelhakim KN, Sampron N, Abdelmonem A, Elwakil LM, Heesters MAAM, van der Weide HL, Bolt RA, Enting RH, Glaudemans AWMJ, Bijl HP, van Dijk JMC, Langendijk JA, Matheu A, Chmielowska E, Lewandowska K, Studzinski M, Olejniczak M, Kwiatkowski M, Subira D, Illan J, Serrano C, Simo M, Pardo J, Ayuso A, Martinez-Garcia M, Gil-Bazo I, Sepulveda JM, Hinojo C, Bruna J, Chmielowska E, Krause A, Swiezynski M, Lewandowska K, Olejniczak M, Paris S, Chung C, Menard C, Stevens C, Laperriere N, Millar B, Bernstein M, Zadeh G, Mason W, Brade A, Kim J, Tejada-Solis S, Pardo J, Bruna J, Gomez L, Subira D, Fernandez A, Serrano C, Gonzalez F, Velasco R, Gil M, Perez-Carrion R, Diez-Valle R, Levivier M, Magaddino V, Negretti L, Tuleasca C, Moeckli R, Auslands K, Liepa Z, Apskalne D, Ozols R, Ogino A, Lopez de Munain A, Hirai T, Fukushima T, Serizawa T, Yachi K, Ohta T, Watanabe T, Yoshino A, Hirayama T, Katayama Y, Slavc I, Manterola L, Chocholous M, Czech T, Peyrl A, Dorfer C, Prucker C, Haberler C, Woehrer A, Azizi A, Antoni D, Clavier J, Alonso MM, Noel G, Antoni D, Clavier J, Noel G, Pardo J, Cuadrado ML, Fernandez C, Broemme JO, Schucht P, Beck J, Weiler M, Abu-Isa J, Kottke R, Malthaner M, Schmidthalter D, Aebersold DM, Pica A, Carpentier A, Peignaux K, Bourgeois H, Fauchon F, Blaes J, Prevost J, Azria D, Toulemonde A, Lortholary A, Bonneterre J, Hennequin C, Du Four S, Wilgenhof S, Neyns B, Lam T, Sahm F, Wong F, Sze W, Tung S, Calabek B, Pollanz S, Surbock B, DeSantis M, Pohnl R, Ammerer H, Sherif C, Pusch S, Grisold W, Hanssens P, Beute G, Karlsson B, Naskhletashvili DR, Gorbounova V, Bychkov M, Bekyashev A, Karakhan V, Aloshin V, Jugold M, Moskvina E, Rudnicka H, Niwinska A, Murawska M, Save A, Baehring JM, Ghali RR, Basiuony ME, Elleithy MA, Martinez-Garcia M, Kempf T, Momprade E, Alameda F, Capellades J, Ruiz I, Vivanco RM, Manero RM, Foro P, Conesa G, Albanell J, Di Stefano A, Weller M, Berzero G, Vitali P, Bastianello S, Giometto B, Salmaggi A, Marchioni E, Velasco R, Simo M, Santos C, Gil M, Platten M, Salazar R, Galan M, Palmero R, Ale A, Bruna J, Lee DZJ, Kheder A, Forbes M, Craven I, Hadjivassiliou M, Wick W, Yevtushenko S, Goncharova Y, Filimonov D, Symonian V, Viaccoz A, Karantoni E, Ducray F, Picard G, Cavillon G, Rogemond V, McDonald KL, Antoine J, Delattre J, Honnorat J, Koekkoek JAF, Sizoo EM, Postma TJ, Heimans JJ, Pasman RW, Deliens L, Taphoorn MJB, Rapkins R, Reijneveld JC, Muller C, Claudel G, Garat E, Beauchesne P, Hassani K, Labrude M, Taillandier L, Logan J, Hurwitz V, Zhau L, Bhangoo R, Ashkan K, Brazil L, Beaney R, Thier K, Calabek B, Tinchon A, Grisold W, Oberndorfer S, Kallio M, Hitchins M, Kaipio M, Baraniskin A, Kuhnhenn J, Schlegel U, Schmiegel W, hahn S, Schroers R, Mrugala MM, Crew LK, Mishima K, Agnihotri S, Suzuki T, Adachi J, Koga T, Fukuoka K, Yanagisawa T, Fujimaki T, Nishikawa R, Gonzalez-Aguilar A, Boisselier B, Polivka M, Gajadhar A, Jouvet A, Adam C, Figarella-Branger D, Miquel C, Vital A, Mokhtari K, Hoang-Xuan K, Sommer B, Grummich P, Hamer HM, Gorlia T, Blumcke I, Coras R, Buchfelder M, Roessler K, Rozumenko VD, Rozumenko AV, Brell M, Roldan P, Gonzalez E, Ibanez J, Margison G, Ibanez J, Brell M, Tomas M, Roldan P, Guibelalde M, Tavera A, Salinas J, Van Geemen K, Klein M, Zwinderman AH, Aldape K, Hillebrand A, Stam CJ, Vandertop WP, De Witt Hamer PC, Senft C, Gessler F, Mittelbronn M, Dutzmann S, Franz K, Hattingen E, Hawkins C, Seifert V, Ngoga DG, Tennant D, Williams A, Cruickshank G, Carrabba G, Bertani G, Cogiamanian F, Ardolino G, Zarino B, Hegi M, Conte V, Caroli M, Gaini SM, Oppido P, Carapella C, Pompili A, Vidiri A, Pace A, Shinoda J, Miwa K, Guha A, Yonezawa S, Aki T, Asano Y, Ito T, Yokoyama K, Yamada M, Yamada J, Ceberg C, Jonsson B, Prezado Y, Simo M, Nittby H, Grafstrom G, Stromblad S, Elleaume H, Baldetorp B, Salford LG, Strand S, Hundsberger T, Brugge D, Weder P, Macia M, Weber J, Plasswilm L, Lopci E, Clerici E, Catalano M, Rodari M, Morenghi E, Mancosu P, Navarria P, Scorsetti M, Plans G, Chiti A, Fernandez M, Setua S, Watts C, Welland M, Martinez Moreno NE, Kusak ME, Gutierrez Sarraga J, Rey Portoles G, Martinez Alvarez R, Majos C, Narayan RS, Renwarin L, van den Berg J, Franken NAP, Stalpers LJA, Baumert BG, Sminia P, Mucha-Malecka A, Sladowska A, Malecki K, Gil M, Glinski B, Kisielewicz K, Torabi Nami M, Hejazi Farahmand S, Mohammadzadeh F, Shao C, Wu M, Xia Y, Chen F, Chen Z, Izquierdo C, Miyatake S, Yoritsune E, Furuse M, Miyata T, Nonoguchi N, Kawabata S, Kuroiwa T, Kuwabara H, Masunaga S, Ono K, Velasco R, Ros T, Horvat Sprah M, Popovic M, Jezersek Novakovic B, Kerrigan SJ, Erridge S, Whittle I, Grant R, Verissimo CS, Molenaar JJ, Bruna J, Meerman J, Puigvert JC, Pont C, Danen EHJ, van de Water B, Versteeg R, Fitzsimons CP, Vreugdenhil E, Marques J, Costa I, Yanagisawa T, Passos J, Azevedo A, Salgado D, Teixeira G, Ferreira I, Guimaraes A, Miranda N, Abecasis M, Bosa C, Magistrello M, Suzuki K, Trevisan E, Morra I, Fiano V, Dealis C, Ruda R, Soffietti R, Mackinnon M, Williamson A, Lamb C, Chalmers A, Fukuoka K, Clark B, James A, Fernandez M, Blanchette M, Tremblay L, Lepage M, Fortin D, Matos Nunes B, Bujor L, Vasconcelos A, Kohga T, Amado A, Monteiro Grillo I, Muggeri AD, Calabrese B, Cerrato S, Cervio A, Diez B, Moser W, Tinchon A, Calabek B, Adachi J, Hitzenberger P, Grisold W, Oberndorfer S, Kusak ME, De Campos JM, Martinez Moreno NE, Gutierrez Sarraga J, Rey Portoles G, Martinez Alvarez R, Kubben PL, MIshima K, De Campos JM, Vinas D, Kusak ME, Lo Presti A, Montoya J, Matsutani M, Fujimaki T, Nisikawa R, Kuhnhenn J, Pels H, Reiser M, Deckert M, Egerer G, Vogt-Schaden M, Schackert G, Kroschinsky F, Schmidt-Wolf IGH, Schlegel U, Schiff D, Taylor JW, Flanagan E, O'Neill BP, Siegal T, Omuro A, Baehring J, Gonzalez-Aguilar A, Chamberlain M, Nishikawa R, Zach L, Guez D, Grober Y, Last D, Daniels D, Hoffman C, Nissim O, Spiegelmann R, Cohen ZR, Mardor Y, Radbruch A, Kramp L, Wiestler B, Heiland S, Wick W, Bendszus M, Colavolpe C, Chinot O, Metellus P, Mancini J, Barrie M, Bequet-Boucard C, Tabouret E, Mundler O, Figarella-Branger D, Guedj E, Berghoff AS, Lassmann H, Hoftberger R, Preusser M, Mercurio-Smit S, Padovani L, Colin C, Andre N, Fernandez C, Figarella-Branger D, Ruda R, Bertero L, Trevisan E, Pace A, Carapella C, Dealis C, Caroli M, Faedi M, Bomprezzi C, Soffietti R, Kunz M, Armbruster L, Thon N, Jansen N, Egensperger R, Eigenbrod S, Lutz J, Fougere la C, Tonn J, Kreth F, Berntsson S, Savitcheva I, Larsson E, Smits A, van den Bent MJ, Brandes AA, Taphoorn MJB, Kros JM, Kouwenhoven M, Delattre JY, Bernsen HJJA, Frenay M, Tijssen CC, Grisold W, Sipos L, Enting RH, French PJ, Dinjens WNM, Vecht CJ, Allgeier A, Lacombe D, Gorlia T, Hoang Xuan K, Weller M, Meisner C, Platten M, Simon M, Nikkhah G, Papsdorf K, Sabel M, Braun C, Reifenberger G, Wick W, Kerrigan SJ, Graham C, Stenning S, Thompson LC, Rooney A, Brada M, Grant R, Beauchesne PD, Faure G, Noel G, Schmitt T, Martin L, Jadaud E, Balvers R, Kloezeman JK, Kleijn A, Kremer A, French PJ, Dirven CMF, Leenstra S, Lamfers MLM, Bougnaud S, Golebiewska A, Oudin A, Brons NHC, Bjerkvig R, Niclou SP, Smith SJ, Ward JH, Wilson M, Rahman C, Rose F, Peet A, Macarthur DC, Grundy RG, Rahman R, Cuppini L, Calleri A, Bruzzone M, Prodi E, Anghileri E, Pellegatta S, Mancuso P, Bertolini F, Finocchiaro G, Eoli M, Lang FF, Shinojima N, Gumin J, Takezaki T, Hossain A, Sevim H, Chung L, Wheeler HT, Baxter RC, McDonald KL, Alentorn A, Marie Y, Boisselier B, Carpentier C, Mokhtari K, Capelle L, Hoang-Xuan K, Sanson M, Delattre J, Idbaih A, Lathia J, Li M, Sathyan P, Hale J, Zinn P, Gallagher J, Wu Q, Carson C, Naik U, Hjelmeland A, Majumder S, Rich J, Sturm D, Witt H, Hovestadt V, Khuong-Quang D, Jones DTW, Korshunov A, Tonjes M, Plass C, Jabado N, Pfister SM, Johansson M, Oudin A, Tiemann K, Bernard A, Keunen O, Fack F, Golebiewska A, Stieber D, Wang B, Hedman H, Niclou SP, Alexiou GA, Vartholomatos G, Karamoutsios A, Voulgaris S, Cho W, Patil S, Burzynski S, Mrowczynski E, Grela K, Moeckel S, Meyer K, Bosserhoff A, Spang R, Leukel P, Proescholdt M, Bogdahn U, Vollmann A, Hau P, Nakabayashi H, Shimizu K, Schroeteler J, Reeker R, Suero E, Stummer W, Ewelt C, Campos B, Gal Z, Baader A, Schneider T, Bageritz J, Schmoch T, Mogler C, Goidts V, Unterberg A, Herold-Mende CC, Hagemann C, Kessler AF, Fett S, Hofmann L, Monoranu CM, Al-Jomah N, Polat B, Patel R, Ernestus RI, Vince GH, Busek P, Balaziova E, Hilser M, Vomelova I, Fejfarova E, Sromova L, Sedo A, Kessler AF, Hagemann C, Hofmann L, Patel R, Linsenmann T, Ernestus RI, Vince GH, Sooman L, Ekman S, Bergqvist M, Gullbo J, Bergstrom S, Johansson M, Wu X, Blomquist E, Lennartsson J, Shimazu Y, Levallet G, Planchard G, Duguet AE, Emery E, Guillamo J, Geffrelot J, Zalcman G, Lechapt-Zalcman E, Sjostrom S, Ghasimi S, Broholm H, Brannstrom T, Johansen C, Collatz-Laier H, Henriksson R, Andersson U, Melin B, Kuratsu J, Nakamura H, Makino K, ducray F, meyronet D, Cartalat-Carel S, Guyotat J, Jouanneau E, Frappaz D, d'Hombres A, Sunyach M, Bauchet L, Honnorat J, Jaramillo E, Vargas C, Tze-Chun T, Huang S, Liu J, Hamdan A, Mitchell P, Flechl B, Ackerl M, Sax C, Oberndorfer S, Calabek B, Sizoo E, Reijenfeld J, Crevenna R, Preusser M, Marosi C, Rozumenko V, Khoroshun A, Rozumenko A, Fischbach P, Haquet A, Dutilleux A, Bracke J, Al Bassir M, Denoel C, Pace A, Villani V, Grattarola C, Di Napoli L, Maschio M, Benincasa D, Zucchella C, Burdukova YA, Vlasova EY, Gniteeva LN, Alekseeva OS, Voronin NA, Andreeva EV, Gorbatykh SV, Pavlova EV, Popov VE, Stroganova TA, Satoer DD, Kloet A, Vincent AJPE, Dirven CMF, Visch-Brink EG, Ungureanu G, Alexandra C, Ioana I, Paul M, Rares M, Oana M, Ioan Stefan F, Abdel Karim K, Abdel Wahab MM, Ezz LR, Abdel Raouf S, Shevtsov MA, Pozdnyakov AV, Kim AV, Samochernych KA, Guzhova IV, Romanova IV, Khachatryan WA, Margulis BA, Kleijn A, Kloezeman JJ, Treffers-Westerlaken EJ, Leenstra S, Dirven CMF, Debets R, Lamfers MML, Chirasani SR, Leukel P, Gronwald W, Gottfried E, Stadler K, Bogdahn U, Hau P, Kreutz M, Grauer OM, Persson BR, Engstrom P, Grafstrom G, Baureus Koch C, Widegren B, Salford LG, Gramatzki D, Peipp M, Staudinger M, Weller M, Hill LJ, Hossain-Ibrahim K, Logan A, Cruickshank GS, Pellegatta S, Eoli M, Antozzi C, Frigerio S, Cantini G, Bruzzone M, Anghileri E, Pollo B, Parati E, Finocchiaro G, Stragliotto G, Holm S, Adamson L, Giraud G, Hansson M, Henter J, Martinez-Garcia M, Villalonga R, Martinez-Soler F, Gimenez-Bonafe P, Acebes JJ, Casanovas O, Gil M, Tortosa A, Vinals F, Sander P, Leukel P, Vollmann-Zwerenz A, Jachnik B, Dobner C, Bogdahn U, Kalbitzer H, Hau P, Weissenberger J, Mutlu A, Hensel S, Senft C, Seifert V, Kogel D, Hossain-Ibrahim K, Hill LJ, Logan A, Cruickshank GS, Jung S, Wen M, Pei J, Jang W, Jung T, Kim I, Ishida J, Ichikawa T, Kurozumi K, Inoue S, Maruo T, Onishi M, Fujii K, Shimazu Y, Chiocca A, Date I, Fujii K, Kurozumi K, Ichikawa T, Onishi M, Shimazu Y, Ishida J, Chiocca E, Kaur B, Date I, Kang S, Sin G, Shim J, Lee S, Huh Y, Kim E, Chang J, Kim S, Hong Y, Kim D, Lefranc F, Verschuere T, De Witte O, Van Gool S, Kiss R, DeVleeschouwer S, Ewelt C, Ardon H, Suero E, Gunes D, Wolfer J, Fischer B, Stummer W, Thorsteinsdottir J, Fu P, Gehrmann M, Multhoff G, Tonn JC, Schichor C, Jachtenberg J, Bakker Schut T, Puppels G, French P, Kros M, Lamfers M, Leenstra S, Costello PC, McDonald W, MacDonald D, Zlatescu M, Megyesi J, Rossetto M, Gallego Perez-Larraya J, Boisselier B, Ciccarino P, Labussiere M, Marie Y, Delattre J, SANSON M, Ilhan-Mutlu A, Wohrer A, Berghoff AS, Widhalm G, Marosi C, Wagner L, Preusser M, Di Stefano A, Gallego Perez-Larraya J, Ducray F, Boisselier B, Labussiere M, Paris S, Cheneau C, Delattre J, Sanson M, Lonnqvist F, Gaillard PJ, Gladdines W, Boogerd W, van Tellingen O, Milojkovic Kerklaan B, Schellens JHM, Brandsma D, Denicolai E, Baeza-Kallee N, Tchoghandjian A, Beclin C, Figarella-Branger D, Rahman CV, Smith SJ, Morgan PS, Langmack KA, Macarthur DC, Rose FR, Shakesheff KM, Grundy RG, Rahman R, Nowosielski M, DiFranco MD, Putzer D, Seiz M, Jacobs AH, Stockhammer G, Hutterer M, Okada M, Shishido H, Hatakeyama T, Shinomiya A, Miyake K, Kawai N, Tamiya T, Miyake K, Shinomiya A, Okada M, Hatakeyama T, Kawai N, Tamiya T, Alexiou GA, Tsiouris S, Papadopoulos A, Al-Bokharhli J, Kyritsis AP, Voulgaris S, Fotopoulos AD, Roelcke U, Boxheimer L, Fathi AR, Schwyzer L, Ortega M, Berberat J, Grobholz R, Remonda L, Oikawa M, Sato K, Ito T, Sugio H, Ozaki Y, Nakamura H, Schwyzer L, Berberat J, Boxheimer L, Remonda L, Roelcke U, Kozic D, Njagulj V, Gacesa JP, Prvulovic N, Semnic R, Basmaci M, Hasturk AE, Hasturk AE, Basmaci M, Bahr O, Weise L, Harter PN, Weiss C, Starzetz T, Steinbach JP, Mittelbronn M, Hattingen E, Price SJ, Young AMH, Thomas OM, Mohsen LA, Frary AJ, Lupson VC, McLean MA, Weiss C, Neuschmelting V, Eisenbeis A, Nettekoven C, Grefkes C, Goldbrunner R, Weiss C, Neuschmelting V, Eisenbeis A, Nettekoven C, Grefkes C, Goldbrunner R, Weiss C, Neuschmelting V, Eisenbeis A, Nettekoven C, Rehme A, Grefkes C, Goldbrunner R, Grech-Sollars M, Saunders DE, Phipps KP, Clayden JD, Clark CA, Schwyzer L, Berberat J, Boxheimer L, Remonda L, Roelcke U, Booth TC, Larkin T, Yuan Y, Kettunen M, Markowetz F, Scoffings D, Jefferies S, Brindle KM, Pica A, Hauf M, Slotboom J, Beck J, Schucht P, Aebersold DM, Wiest R, Pace A, Marzi S, Fabi A, Carapella CM, Giovinazzo G, Marucci L, Anelli V, Vidiri A, Riva M, Castellano A, Raneri F, Pessina F, Fava E, Falini A, Bello L, Gahramanov S, Muldoon LL, Varallyay CG, Li X, Kraemer DF, Fu R, Hamilton BE, Rooney WD, Neuwelt EA, Hawkins-Daarud A, Rockne R, Muzi M, Patridge S, Kinahan P, Swanson KR, Radbruch A, Fladt J, Wiestler B, Baumer P, Heiland S, Wick W, Bendszus M, Lwin M, Al-Salihi O, Sharpe G, Izmailov TR, Panshin GA, Datsenko PV, Kavsan VM, Balynska EV, Chernolovskaya EL, Zenkova MA, Buhl RM, Janz C, Gomez Gallego J, Albanna W, Rashidi A, Schmiegelow P, Buhl RM, Alexiou GA, Vartholomatos G, Karamoutsios A, Voulgaris S, Shen D, Wang J, Qiu Z, Chen F, Chen Z, Miwa K, Shinoda J, Ito T, Yokoyama K, Yamada M, Yamada J, Yano H, Iwama T, Brokinkel B, Schober O, Heindel W, Hargus G, Paulus W, Stummer W, Woelfer J, Aoki T, Arakawa Y, Ueba T, Miyatake S, Nozaki K, Taki W, Tsukahara T, Miyamoto S, Matsutani M, Satou K, Ito T, Takanashi M, Oikawa M, Ozaki Y, Sugio H, Nakamura H. Abstracts of the 10th Congress of the European Association of NeuroOncology. Marseille, France. September 6-9, 2012. Neuro Oncol 2012; 14 Suppl 3:iii1-109. [PMID: 22977921 DOI: 10.1093/neuonc/nos183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Nagasawa DT, Bergsneider M, Kelly D, Shafa B, Duong D, Ausman J, Liau L, McBride D, Yang I, Mann BS, Yabroff R, Harlan L, Zeruto C, Abrams J, Gondi V, Eickhoff J, Tome WA, Kozak KR, Mehta MP, Field KM, Drummond K, Yilmaz M, Gibbs P, Rosenthal MA, Allaei R, Johnson KJ, Hooten AJ, Kaste E, Ross JA, Largaespada DA, Johnson DR, O'Neill BP, Rice T, Zheng S, Xiao Y, Decker PA, McCoy LS, Smirnov I, Patoka JS, Hansen HM, Wiemels JL, Tihan T, Prados MD, Chang SM, Berger MS, Pico A, Rynearson A, Voss J, Caron A, Kosel ML, Fridley BL, Lachance DH, O'Neill BP, Giannini C, Wiencke JK, Jenkins RB, Wrensch MR, Xiao Y, Decker PA, Rice T, Hansen HM, Wiemels JL, Tihan T, Prados MD, Chang SM, Berger MS, Kosel ML, Fridley BL, Lachance DH, O'Neill BP, Buckner JC, Burch PA, Thompson RC, Nabors LB, Olson JJ, Brem S, Madden MH, Browning JE, Wiencke JK, Egan KM, Jenkins RB, Wrensch MR, Pereira EA, Livermore J, Alexe DM, Ma R, Ansorge O, Cadoux-Hudson TA, Johnson DR, O'Neill BP, Wang M, Dignam J, Won M, Curran W, Mehta M, Gilbert M, Terry AR, Barker FG, Leffert LR, Bateman B, Souter I, Plotkin SR, Ishaq O, Montgomery J, Terezakis S, Wharam M, Lim M, Holdhoff M, Kleinberg L, Redmond K, Kruchko C, Paker AM, Chi TL, Kamiya-Matsuoka C, Loghin ME, Lautenschlaeger T, Dedousi-Huebner V, Chakravarti A. EPIDEMIOLOGY. Neuro Oncol 2011. [DOI: 10.1093/neuonc/nor149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kitzmann AS, Pulido JS, Mohney BG, Baratz KH, Grube T, Marler RJ, Donaldson MJ, O'Neill BP, Johnston PB, Johnson KM, Dixon LE, Salomao DR, Cameron JD. Intraocular use of rituximab. Eye (Lond) 2007; 21:1524-7. [PMID: 17464308 DOI: 10.1038/sj.eye.6702804] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To evaluate the toxicity of 1 mg of intraocular rituximab and to present a small case-series of patients treated with intravitreal rituximab. METHODS Rituximab (1 mg/0.1 ml) was injected in the vitreous of one eye of three Dutch-belted rabbits. Two animals were injected with balanced salt solution as controls. At 1 month the rabbits were killed and the eyes examined by light microscopy. Three patients (five eyes) with intraocular lymphoma were also treated with a 1 mg injection of rituximab. RESULTS The treated rabbit eyes and the control eyes showed no light microscopic evidence of ocular toxicity at 1 month following injection. The five human eyes of three patients have shown no evidence of intraocular toxicity with a median follow-up time of 3.6 months (range 2.0-6.4 months). One patient received a total of four injections in the right eye and three injections in the left eye. CONCLUSION Intravitreal rituximab at a dose of 1 mg does not appear to cause toxicity in rabbit eyes and in the five eyes of three patients.
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Affiliation(s)
- A S Kitzmann
- Department of Ophthalmology, Mayo Clinic, Rochester, MN, USA
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Abstract
A clinical pain syndrome similar to "carotidynia" developed in a patient several years after undergoing carotid endarterectomy. The pain was reversed by superior laryngeal nerve block, followed by superior larnygeal neurectomy. A diagnosis of superior laryngeal neuralgia was suggested by several characteristic features: (1) pain along the anterior cervical triangle, with extension to the ipsilateral ear and eye, (2) hoarseness, and (3) paralysis of the ipsilateral cricothyroid muscle on laryngoscopy. Carotidynia usually refers to neck pain arising from the carotid artery in the neck and is often viewed as a migraine variant. Our observations suggest that carotidynia may not be a migraine variant and that "carotidynia" may not be an accurate term for all pains in the anterior cervical triangle. We suggest that evaluation of neck pain include speech pathology and otolaryngologic consultations (including laryngoscopy) if any voice disorder is reported or noted. Since the superior laryngeal nerve is the neural structure most contiguous to the bifurcation of the carotid artery, the superior laryngeal nerve may have become entrapped in a fibrotic process that developed after carotid endarterectomy. Such pain may be a rare complication of carotid endarterectomy. When other causes have been excluded and pain continues, a superior laryngeal nerve block should be considered.
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Affiliation(s)
- B P O'Neill
- Department of Neurology , Mayo Clinic and Mayo Foundation, 200 First Street SW, Rochester, MN 55901, USA
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Meyer FB, Bates LM, Goerss SJ, Friedman JA, Windschitl WL, Duffy JR, Perkins WJ, O'Neill BP. Awake craniotomy for aggressive resection of primary gliomas located in eloquent brain. Mayo Clin Proc 2001; 76:677-87. [PMID: 11444399 DOI: 10.4065/76.7.677] [Citation(s) in RCA: 121] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To determine with intraoperative neurologic and language examinations the maximal tumor resection achievable with acceptable postoperative neurologic dysfunction in patients undergoing awake stereotactic glial tumor resection in eloquent regions of the brain. PATIENTS AND METHODS Between October 1995 and December 2000, 65 patients underwent frameless stereotactic resection of glial tumors located in functioning tissue. During the resection, continuous examinations by a neurologist and speech pathologist were performed. The goal of surgery was to resect the maximum neurologically permissible tumor volume defined on preoperative T2 imaging. Tumor resection was stopped at the onset of neurologic dysfunction. Novel segmentation software was used to measure tumor cytoreduction based on pre- and postoperative magnetic resonance imaging. All patients underwent 3-month postoperative neurologic examinations to determine functional outcomes. RESULTS The cortical and subcortical white matter tracts at risk for injury were the left frontal operculum in 15 patients, the central lobule in 38, the insula in 11, and the left angular gyrus in 1. Thirty-four (52%) had a greater than 90% reduction in T2 signal postoperatively. In 26 patients thought to have low-grade tumors based on preoperative imaging, 12 proved to have grade 3 gliomas. Forty-eight patients (74%) developed intraoperative deficits; 34 (71%) recovered to a modified Rankin grade of 0 or 1 at 3 months postoperatively, 11 (23%) achieved a modified Rankin grade of 2, and 3 patients (6%) achieved a modified Rankin grade of 3 or 4 at 3-month follow-up. There was no operative mortality; 17 patients (26%) died from tumor progression during the follow-up period. CONCLUSIONS Combining frameless computer-guided stereotaxis with cortical stimulation and repetitive neurologic and language assessments facilitates tumor resection in functioning brain regions. Resecting tumor until the onset of neurologic deficits allows for a good functional recovery. Imaging software can objectively and accurately measure preoperative and postoperative tumor volumes.
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Affiliation(s)
- F B Meyer
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minn 55905, USA.
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Abstract
The records and neuro-imaging studies of 8 cases of posttransplant primary CNS lymphoma (PT-PCNSL) diagnosed at Mayo Clinic Rochester between 1970 and 1998 were reviewed retrospectively. All patients received organ transplantation. Patients who had hematologic transplantation were not included in the analysis. The median and mean age of the 4 men and 4 women was 45 years (range, 34 to 50 years). The median duration of symptoms before diagnosis was 36 days (range, 5 to 98 days). At diagnosis, the neurologic examination was focally abnormal in 6 of 8 patients. Compared with the initial computed tomographic study, MRI showed 25 additional brain lesions. Only 43.7% of lesions enhanced with contrast agent; of those that did, all but one were heterogeneous. Ependymal contact occurred in 5 patients. MRI lesion burden increased proportionally to the interval between scans. Diagnostic tissue was obtained by stereotactic biopsy from 6 patients and by open biopsy from 2. Hemorrhage occurred in the biopsy area in 4 patients who had stereotactic biopsy and 2 died (all had normal coagulation studies). Slides available for review (7 patients) showed that the tumors were of CD20-positive lineage and were positive for Epstein-Barr virus, using in situ hybridization. Six patients died. Median survival for the cohort was 13 weeks. PT-PCNSL has clinical and imaging features distinct from typical PCNSL. In our series, (1) PT-PCNSL presented nonspecifically and progressed rapidly, (2) stereotactic brain biopsy had significant morbidity, and (3) despite multimodal therapy, survival was poor.
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Affiliation(s)
- T G Phan
- Department of Neurology, Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA
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Abstract
The records and neuro-imaging studies of 8 cases of posttransplant primary CNS lymphoma (PT-PCNSL) diagnosed at Mayo Clinic Rochester between 1970 and 1998 were reviewed retrospectively. All patients received organ transplantation. Patients who had hematologic transplantation were not included in the analysis. The median and mean age of the 4 men and 4 women was 45 years (range, 34 to 50 years). The median duration of symptoms before diagnosis was 36 days (range, 5 to 98 days). At diagnosis, the neurologic examination was focally abnormal in 6 of 8 patients. Compared with the initial computed tomographic study, MRI showed 25 additional brain lesions. Only 43.7% of lesions enhanced with contrast agent; of those that did, all but one were heterogeneous. Ependymal contact occurred in 5 patients. MRI lesion burden increased proportionally to the interval between scans. Diagnostic tissue was obtained by stereotactic biopsy from 6 patients and by open biopsy from 2. Hemorrhage occurred in the biopsy area in 4 patients who had stereotactic biopsy and 2 died (all had normal coagulation studies). Slides available for review (7 patients) showed that the tumors were of CD20-positive lineage and were positive for Epstein-Barr virus, using in situ hybridization. Six patients died. Median survival for the cohort was 13 weeks. PT-PCNSL has clinical and imaging features distinct from typical PCNSL. In our series, (1) PT-PCNSL presented nonspecifically and progressed rapidly, (2) stereotactic brain biopsy had significant morbidity, and (3) despite multimodal therapy, survival was poor.
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Affiliation(s)
- T G Phan
- Department of Neurology, Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA
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Fonseca R, Habermann TM, Colgan JP, O'Neill BP, White WL, Witzig TE, Egan KS, Martenson JA, Burgart LJ, Inwards DJ. Testicular lymphoma is associated with a high incidence of extranodal recurrence. Cancer 2000; 88:154-61. [PMID: 10618618 DOI: 10.1002/(sici)1097-0142(20000101)88:1<154::aid-cncr21>3.0.co;2-t] [Citation(s) in RCA: 129] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Testicular lymphoma is a rare extranodal presentation of non-Hodgkin lymphoma. The authors report long term follow-up information regarding a group of patients with testicular lymphoma evaluated at the Mayo Clinic and describe the outcome with special attention to patterns of recurrence. METHODS The medical records of patients with testicular lymphoma seen at the Mayo Clinic between January 1970 and March 1993 were reviewed. Patients were included if they had evidence of testicular involvement at the time of diagnosis of lymphoma. Pathology specimens were reviewed for confirmation of diagnosis. RESULTS Sixty-two patients with a diagnosis of testicular lymphoma were identified. Their median age was 68 years, and 60 patients underwent orchiectomy as the initial therapeutic and diagnostic procedure. Most of patients (79%) had localized or regional disease at the time of presentation. Other treatment modalities after diagnosis included radiotherapy (37%), combination chemotherapy (37%), and combination chemotherapy and radiotherapy (16%). Although 88% of patients had no residual disease after primary treatment, 80% subsequently experienced disease recurrence. There was no significant difference in the rate of recurrence, including Ann Arbor Stage I disease. Treatment did not appear to affect the recurrence rate. At a median follow-up of 2.7 years, 60% of patients had died of disease. Late recurrences were observed, and there appeared to be no plateau in the disease free survival curve. In half (51%) of the patients with disease recurrence, only extranodal locations were involved. Thirteen patients experienced recurrence in the central nervous system, 11 of whom had parenchymal lesions. In 8 of these 13 patients, the central nervous system was an isolated site of disease recurrence. CONCLUSIONS Testicular lymphoma is a unique and aggressive extranodal non-Hodgkin lymphoma. Better treatment strategies are needed to prevent recurrences. The risk of extranodal recurrence is high, especially in the central nervous system.
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Affiliation(s)
- R Fonseca
- Division of Hematology and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA
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O'Neill BP, Habermann TM, Witzig TE, Rodriguez M. Prevention of recurrence and prolonged survival in primary central nervous system lymphoma (PCNSL) patients treated with adjuvant high-dose methylprednisolone. Cancer Immunol Immunother 1999; 16:211-5. [PMID: 10523802 DOI: 10.1007/bf02906134] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Five patients at risk for primary central nervous system lymphoma (PCNSL) recurrence were treated with high-dose methylprednisolone (HDMP) to prevent 'trafficking' of malignant lymphocytes into the central nervous system (CNS). HDMP was chosen because of its ability to stabilize the 'blood brain barrier (BBB)'. Three men with newly diagnosed PCNSL, ages 62, 76 and 78y, whose survival was projected to be 6.6 months, began treatment after achieving complete response (CR) to initial radiation therapy alone and survived 27, 37 and 59 months after treatment. In none was death from recurrent disease in CNS but one patient did die of systemic non-Hodgkin's lymphoma (NHL) five years after PCNSL diagnosis. A 20 y old man was treated with HDMP after successful combined modality therapy and is alive 75+ months after initial diagnosis without evidence of disease recurrence. A 34 y old man relapsed after combined modality initial treatment and failed to respond to HDMP when treatment was begun after unsuccessful salvage therapy; he died of disease 12 months after initial diagnosis. There were no treatment complications. The promising results in this pilot study from the basis for a North Central Cancer Treatment Group (NCCTG) 96-73-51, a Phase 2 clinical trial of brain radiotherapy and HDMP for PCNSL patients 70y of age and older, a group of patients at high risk for toxicity from intensive combined modality therapy.
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Affiliation(s)
- B P O'Neill
- Department of Neurology, Mayo Clinic, and the Mayo Clinic Cancer Center, Rochester, MN 55905, USA.
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O'Neill BP. The consequences of treatment and disease in patients with primary CNS non-Hodgkin's lymphoma: Cognitive function and performance status. Neuro Oncol 1999. [DOI: 10.1215/15228517-1-3-196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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O'Neill BP, Wang CH, O'Fallon JR, Colgan JP, Earle JD, Krigel RL, Brown LD, McGinnis WJ. The consequences of treatment and disease in patients with primary CNS non-Hodgkin's lymphoma: cognitive function and performance status. North Central Cancer Treatment Group. Neuro Oncol 1999; 1:196-203. [PMID: 11554388 PMCID: PMC1920741 DOI: 10.1093/neuonc/1.3.196] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Per protocol, patients with primary CNS non-Hodgkin's lymphoma in an intergroup phase II trial conducted by the North Central Cancer Treatment Group and the Eastern Cooperative Oncology Group had their cognitive functions measured using the Folstein and Folstein Mini-Mental Status Examination (MMSE) and their physical functions measured using the Eastern Cooperative Oncology Group Performance Score (PS) at study entry, at each treatment evaluation, and at quarterly intervals thereafter until disease progression or death. Of the 53 eligible participants who began therapy, 46 (87%) had baseline MMSE scores recorded, 36 (68%) had at least one follow-up MMSE, and 32 (60%) had both, while 52 (98%) had baseline PS, 49 (92%) had at least one follow-up PS, and 48 (91%) had both. Patterns of MMSE and PS values over time were studied in each individual, in the group as a whole, in the 20 patients who completed the study regimen, in the 23 who survived more than a year, and in patients who were classified as nonprogressors at each key evaluation. For each patient, all recorded values were plotted versus time, with dates of disease progression and death included, to look for signs of decline in cognitive or physical function preceding adverse events. Long-term declines in scores of both cognitive and physical function were observed in many treated patients with primary CNS non-Hodgkin's lymphoma. Nearly all patients who were alive more than 52 weeks after study entry had a demonstrable decline in cognitive and physical functionality. Such declines may occur before disease progression is documented; they may also occur in some patients who have long-term follow-up without evidence of disease progression. Declining MMSE and PS was a poor predictor of disease progression. There was no association of PS and toxicity. The data from this study demonstrated the considerable difficulties we encountered conducting an ancillary study such as this within a multicenter clinical trial. Firstly, the test instruments written into the protocol were unable to tell if the declines seen were due to disease, treatment, co-morbidity, or other factors. Secondly, the missing data created difficulties in interpreting outcome.
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Affiliation(s)
- B P O'Neill
- Department of Neurology, Mayo Clinic and Foundation, 200 SW First St., Rochester, MN 55905, USA
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Abstract
BACKGROUND Pleomorphic xanthoastrocytomas (PXA) may recur and demonstrate aggressive clinical behavior with a mortality rate between 15% and 20%. To the authors' knowledge, no histopathologic features currently are known to reliably predict recurrence or tumor progression. METHODS The study was based on 71 cases with available information regarding clinical and therapeutic data and follow-up. Diagnostic features included cellular pleomorphism, giant and/or xanthic cells, eosinophilic granular bodies, desmoplasia, and leptomeningeal involvement. The mitotic index (MI), the presence of necrosis, and endothelial proliferation were recorded in all primary resection specimens. RESULTS The study included 35 females and 36 males, age 26+/-16 years (mean +/- standard deviation). Approximately 98% of tumors were supratentorial, with 49% in the temporal lobe. Seizures were the presenting symptoms in 71% of patients. Extent of tumor removal was macroscopic total resection in 68% of cases and subtotal resection (STR) in 32% of cases. Postoperative radiotherapy, alone or with chemotherapy, was administered in 29% and 12.5% of cases, respectively. The recurrence free survival rates (RFS) were 72% at 5 years and 61% at 10 years, whereas overall survivals rates (OS) were 81% at 5 years and 70% at 10 years. In univariate analysis, the extent of resection was the single factor associated most strongly with RFS (P=0.003), followed by MI (P=0.007) and atypical mitoses (P=0.04). Necrosis was not found to be significant. The extent of resection and MI were confirmed as independent predictors of RFS by multivariate analysis. MI (P=0.001), atypical mitoses (P=0.02), and necrosis (P=0.04) were associated with OS by univariate analysis. In multivariate analysis, only MI was an independent predictor of survival. Information regarding MIB-1 labeling index and the use of adjuvant therapy was too limited to explore their prognostic significance confidently. CONCLUSIONS The study confirms that PXA is an astrocytic tumor with a relatively favorable prognosis. MI and extent of resection appear to be the main predictors of RFS and OS. Given the slow growth of the tumor, more studied cases and longer periods of follow-up will be essential to confirm our findings regarding prognostic factors affecting this unusual tumor.
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Affiliation(s)
- C Giannini
- Department of Pathology, Mayo Clinic, Rochester, Minnesota 55905, USA
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Abstract
OBJECTIVE To present the clinical characteristics of patients enrolled in a trial of treatment of small cell carcinoma (SCC) of the lung and to describe the central nervous system toxicity associated with the chemotherapy and prophylactic cranial irradiation (PCI). MATERIAL AND METHODS We performed a retrospective analysis of 60 patients with SCC who received chemotherapy and thoracic radiation therapy. PCI was administered to patients who had limited disease or who had extensive disease that was subsequently down-staged to only residual chest disease after initial treatment. The total PCI dose was 3,200 cGy administered in 16 fractions of 200 cGy, given concurrently with systemic chemotherapy. Diagnostic criteria for leukoencephalopathy were based on previously published guidelines. RESULTS Of the 60 eligible and enrolled patients, 35 received PCI and 25 did not. Leukoencephalopathy developed in 5 of the 35 patients (14%) who received PCI. The median age of the patients in whom leukoencephalopathy developed was 64 years (range, 57 to 69), and the median follow-up time was 59 months. The most common signs and symptoms of leukoencephalopathy were intellectual changes, memory alterations, and motor abnormalities. The mean time to onset of symptoms after termination of irradiation was 357 days (range, 30 to 524). Of all 60 patients, 6 were still alive 4 years after enrollment, and 3 of them (50%) already had leukoencephalopathy. CONCLUSION Small dosage fractions of PCI may still result in leukoencephalopathy. The routine use of PCI in the management of SCC should be reassessed because of increasing evidence of the toxicity associated with it.
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Affiliation(s)
- R Fonseca
- Division of Medical Oncology, Mayo Clinic Rochester, Minnesota 55905, USA
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Molnár PP, O'Neill BP, Scheithauer BW, Groothuis DR. The blood-brain barrier in primary CNS lymphomas: ultrastructural evidence of endothelial cell death. Neuro Oncol 1999; 1:89-100. [PMID: 11550310 PMCID: PMC1920754 DOI: 10.1093/neuonc/1.2.89] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The vasculature of 24 primary CNS B-cell lymphomas that were not related to acquired immunodeficiency syndrome was systematically studied by electron microscopy. Seven low-grade astrocytic tumors were included for comparison. Classical electron microscopy features of apoptosis were found in lymphoma cells of 21 of 22 subjects. Capillaries of gliomas and lymphomas showed changes reported previously: variability of endothelial cell (EC)-thickness and number, basal lamina thickness and duplication, and fenestrations. Primary CNS B-cell lymphoma ECs showed two distinctive populations of electron-dense and electron-lucent cells. The electron-dense ECs occurred in 38% of all capillaries, with changes consisting of chromatin condensation in bizarre and contracted nuclei, cytoplasmic shrinkage with markedly increased electron density, and dilatation of the endoplasmic reticulum. We interpreted these changes as indicative of apoptosis. Cell death eventually resulted in complete disintegration of the endothelium with frank discontinuities of the EC component of the blood-tumor barrier in capillaries and postcapillary venules. Another population of ECs had increased cell volume, conspicuous cytoplasmic electron lucency, dispersed organelles, scattered vesicles, and apical stress fibers. We interpreted these changes as indicative of cellular regeneration. Individual apoptotic ECs often lay next to normal or regenerating ECs. Neither type of EC change was observed in gliomas, which also lacked perivascular neoplastic lymphocytic cuffing. We believe that these populations of ECs, which have not been described in other disorders affecting the blood-brain barrier, may be induced by cytokines released from necrotic and/or apoptotic tumor lymphocytes and may explain the unusual imaging characteristics of primary CNS B-cell lymphomas treated with corticosteroids.
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Affiliation(s)
- P P Molnár
- Department of Neurology, Northwestern University Medical School, Evanston Northwestern Healthcare, Evanston, IL 60201, USA
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24
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Alberts SR, Bretscher M, Wiltsie JC, O'Neill BP, Mokri B, Witzig TE. Thrombosis related to the use of L-asparaginase in adults with acute lymphoblastic leukemia: a need to consider coagulation monitoring and clotting factor replacement. Leuk Lymphoma 1999; 32:489-96. [PMID: 10048421 DOI: 10.3109/10428199909058406] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
L-asparaginase (L-asp) has become an important component of combination chemotherapy for acute lymphoblastic leukemia (ALL). However, L-asp can produce depletions in many of the clotting factors with an associated risk for thrombosis and hemorrhage. Three consecutive patients seen at the Mayo Clinic with L-asp related thrombosis are described and an in-depth review of the literature is provided. Two of the 3 patients developed central nervous system (CNS) complications with evidence of thrombosis and hemorrhagic infarction. Two of the patients also developed extensive upper extremity thrombosis. The results of comprehensive hemostatic surveys showed marked abnormalities in all 3 patients. Many of the thrombotic complications related to L-asp involve the CNS, as illustrated in 2 of our patients. These patients should be treated aggressively since full recovery is possible. The precise cause of thrombosis is yet to be determined but is likely multifactorial. The optimal treatment and prevention of thrombosis in this group of patients remains poorly defined.
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Affiliation(s)
- S R Alberts
- Department of Neurology, Mayo Clinic, Rochester, Minnesota 55905, USA
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25
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O'Neill BP, Wang CH, O'Fallon JR, Colgan JD, Earle JD, Krigel RL, Brown LD, McGinnis WL. Primary central nervous system non-Hodgkin's lymphoma (PCNSL): survival advantages with combined initial therapy? A final report of the North Central Cancer Treatment Group (NCCTG) Study 86-72-52. Int J Radiat Oncol Biol Phys 1999; 43:559-63. [PMID: 10078637 DOI: 10.1016/s0360-3016(98)00450-7] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE We herein report updated survival and toxicity data on the entire cohort of 53 eligible patients treated on North Central Cancer Treatment Group (NCCTG) protocol 86-72-52, which is now closed. METHODS AND MATERIALS An initial report was published in this journal in 1995. No substantive changes in the conclusions of that report were identified in this analysis. Median survival was 9.6 months for the entire cohort; median survival for the 20 patients who completed the prescribed protocol treatment was 20.7 months. The hematologic and non-hematologic toxicity distributions are virtually the same as those reported in the original paper. RESULTS Results are given for the entire group and for subsets defined by age < or = 60 versus > 60 years, and < 70 versus > or = 70 years of age. CONCLUSIONS No significant differences were observed in any of the outcome variables by age group. There was, however, a nonsignificant suggestion of poorer outcome in those who were > 60 years of age.
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Affiliation(s)
- B P O'Neill
- Department of Neurology, Mayo Clinic/Foundation, Rochester, MN 55905, USA.
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26
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Schiff D, O'Neill BP, Wang CH, O'Fallon JR. Neuroimaging and treatment implications of patients with multiple epidural spinal metastases. Cancer 1998; 83:1593-601. [PMID: 9781953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
BACKGROUND Although multiple spinal epidural metastases (MEMs) commonly occur in cancer patients, their clinical significance remains uncertain. The authors attempted to ascertain the incidence of MEMs and their association with the completeness of spinal imaging by magnetic resonance (MR) scanning versus myelography to determine how often they are missed because of incomplete spinal imaging and to assess their prognostic and treatment implications. METHODS A review of 337 epidural spinal cord compression (ESCC) cases seen at the Mayo Clinic between 1985 and 1993 was conducted. RESULTS ESCC patients undergoing myelography only were significantly more likely to undergo complete spinal imaging (CSI)than patients undergoing either MR scan only or both imaging modalities (P < 0.0001). MEMs were detected in 32% of patients undergoing CSI and 18% of patients with incomplete spinal imaging (P=0.02). Failure to image the cervical spine in patients with symptomatic thoracic or lumbar epidural lesions would have missed secondary epidural lesions in only 1% of patients; however, this figure increased to 21% for failure to image either the thoracic or lumbosacral spine when symptomatic disease was located elsewhere. Radiation oncologists included secondary epidural deposits in treatment ports in 93% of MEM cases. In a multivariate model, the presence of MEMs was an independent prognostic factor for poorer survival. CONCLUSION The incidence of MEMs in patients with ESCC is approximately 30%, and their presence frequently alters treatment plans. It appears safe to forgo cervical spine MR scanning in patients with radiographically verified thoracic or lumbar ESCC; however, careful imaging of the thoracic and lumbar spine should be considered in all ESCC patients to detect MEMs.
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Affiliation(s)
- D Schiff
- Department of Neurology, Mayo Cancer Center, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA
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27
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Moser HW, Moser AB, Frayer KK, Chen W, Schulman JD, O'Neill BP, Kishimoto Y. Adrenoleukodystrophy: increased plasma content of saturated very long chain fatty acids. 1981. Neurology 1998; 51:334 and 9 pages following. [PMID: 9709997 DOI: 10.1212/wnl.51.2.334-a] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
With a new method we measured the saturated very long chain fatty acids in the plasma of adrenoleukodystrophy (ALD) hemizygotes, ALD heterozygotes, and controls. ALD hemizygotes showed increased levels of hexacosanoate (C26 fatty acid) which represented 0.081 ± 0.0066% (SEM) of total fatty acids, compared to 0.015 ± 0.0032% in the controls. C25, C24, and C23 fatty acids were also increased, but the C22 and C20 fatty acids were normal. C26 levels were also increased in most ALD heterozygotes, with a mean level 0.057± 0.0063% of total fatty acids. The technique can be used for diagnosis and carrier identification, and in the evaluation of therapy.
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Schiff D, Suman VJ, Yang P, Rocca WA, O'Neill BP. Risk factors for primary central nervous system lymphoma: a case-control study. Cancer 1998; 82:975-82. [PMID: 9486590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The incidence of primary central nervous system lymphoma (PCNSL) has increased over time in both immunocompetent and immunodeficient individuals. The reasons for the increase among immunocompetent patients are unclear. METHODS The authors conducted a case-control study of PCNSL at the Mayo Clinic based on cases from local community and referral practices. Cases were all PCNSL patients without immunodeficiency diagnosed between 1975 and 1994 (n = 109). Two groups of controls were selected from the same referral practice, namely, patients with other cancer (cancer controls; n = 101), and patients with a different neurologic disease (neurologic controls; n = 109) seen at our institution during the same time period. RESULTS PCNSL was significantly associated with lower education when cases were compared with cancer controls but only suggestively when cases were compared with neurologic controls. PCNSL cases were less likely to have had a history of tonsillectomy or oral contraceptive use compared with both control groups. The findings regarding autoimmune disorders and cardiovascular diseases were inconsistent for the two control groups. Neither farming nor prior personal or family history of cancer appeared to be risk factors for PCNSL. CONCLUSIONS The findings of this study warrant further investigation of tonsillectomy and oral contraceptives as possible factors for PCNSL.
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Affiliation(s)
- D Schiff
- Department of Neurology, Mayo Clinic and Foundation and the Mayo Cancer Center, Rochester, Minnesota 55905, USA
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31
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Affiliation(s)
- P C Burger
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA
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32
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Schiff D, O'Neill BP, Suman VJ. Spinal epidural metastasis as the initial manifestation of malignancy: clinical features and diagnostic approach. Neurology 1997; 49:452-6. [PMID: 9270576 DOI: 10.1212/wnl.49.2.452] [Citation(s) in RCA: 188] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The objective of our study was to delineate clinical features and specific diagnostic and therapeutic implications of spinal epidural metastasis (SEM) occurring as the initial manifestation of malignancy (IMM)-a less common event than SEM in the setting of previously established malignancy (PEM). We performed a retrospective review of the clinical histories of 337 patients seen at Mayo Clinic with a radiographically verified diagnosis of SEM between January 1, 1985, and December 31, 1993. Twenty percent of all cases of SEM occurred as SEM-IMM. Carcinoma of the lung, cancer of unknown primary site, multiple myeloma, and non-Hodgkin's lymphoma were disproportionately represented in SEM-IMM, together accounting for 78% of SEM-IMM patients and only 26% of SEM-PEM patients. Inversely, breast and prostate carcinoma contributed only 12% of SEM-IMM patients but 51% of SEM-PEM patients. Only 27% of patients with SEM-IMM had nonspecific symptoms suggesting malignancy, and in only 24% did the history or physical examination suggest the primary site of malignancy. Percutaneous needle biopsy of the vertebral lesion was diagnostic of malignancy in 18 of 19 patients (95%), and no complications ensued. Fifteen patients underwent diagnostic laminectomy with biopsy, and one had a fatal complication. Survival after the diagnosis of SEM did not differ between patients with SEM-IMM and those with SEM-PEM; the median survival was 6.6 months. SEM not uncommonly occurs as the presentation of malignancy, and often it produces the only symptoms or signs of malignancy. The great majority of neoplasms presenting with SEM are carcinomas of the lung, unknown primary lesions, and hematologic malignancies. Computed tomography-guided needle biopsy is a safe, efficacious means of diagnosing malignancy, allowing for rational diagnostic workup and staging. In most patients it obviates a diagnostic spinal surgical procedure.
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Affiliation(s)
- D Schiff
- Department of Neurosurgery, University of Pittsburgh Medical Center, PA 15213, USA
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33
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Abstract
Our objective was to delineate clinical features and treatment outcome of patients with intramedullary spinal cord metastasis (ISCM). There are no reports of a large experience with this rare cancer complication. We reviewed records retrospectively from 1980 to 1993 to identify patients with histologically confirmed systemic cancer, clinical features of myelopathy, and either tissue-proven ISCM or abnormal neuroimaging findings consistent with ISCM. We identified 40 patients who fulfilled these criteria. In nine, ISCM was the initial presentation of cancer. Nineteen patients had lung primaries (small cell in 12). Twenty-one patients had pain, 35 had demonstrable sensory loss, 37 had weakness, and 25 had urinary incontinence at presentation. Nine patients had true Brown-Séquard syndrome and nine others had pseudo-Brown-Séquard syndrome. Median duration of symptoms at diagnosis was 28 days (range 3 days to 18 months). Thirteen patients had prior brain metastasis, nine had brain metastasis simultaneous with ISCM, and one had brain metastasis after ISCM; 11 had concomitant leptomeningeal metastases. Spinal magnetic resonance findings were abnormal in 30/30 patients, myelographic results were abnormal in 16/20, and eight had pathologic confirmation of ISCM. Thirty-five patients had radiotherapy and five had surgery; four were untreated or treated elsewhere. Median survival was 4 months for patients receiving radiotherapy and 2 months for patients not receiving radiotherapy. Eleven patients survived > 6 months. Twenty-three were ambulatory at ISCM diagnosis, and 21 were ambulatory at letest follow-up. We conclude that ISCM as the initial presentation of malignancy is not rare, and hemicord syndromes occur frequently. Although long-term survival is poor, treatment preserves ambulation in most patients still ambulatory at diagnosis. Focal radiotherapy is indicated in most patients.
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Affiliation(s)
- D Schiff
- Division of Neuro-Oncology, Mayo Clinic, Rochester, MN 55905, USA
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Abstract
OBJECTIVE To describe the diagnosis, management, and outcome in 10 patients with histologically confirmed primary spinal epidural non-Hodgkin's lymphoma. MATERIAL AND METHODS We review the findings in a cohort of seven men and three women in whom this tumor was diagnosed between January 1979 and January 1993 and discuss the prognostic differences between primary and secondary spinal lymphomas. RESULTS All patients (median age at diagnosis, 70 years) underwent a decompressive laminectomy, subtotal tumor resection, and spinal irradiation (median dose, 3,800 cGy). Nine of 10 tumors were of B-cell origin. Six patients are alive and well. In four patients, recurrent disease developed from 15 to 62 months after the original diagnosis; of these, one has died. The median duration of survival of all patients was 42 months; of those living more than 24 months after diagnosis, the median duration of survival was 80 months. CONCLUSION A rapidly progressive spinal cord or cauda equina syndrome with neuroimaging findings consistent with an extradural compressive lesion should alert caregivers to the possibility of spinal epidural lymphoma. Although the prognosis for patients with secondary spinal epidural non-Hodgkin's lymphoma is often poor, primary spinal epidural non-Hodgkin's lymphoma can be associated with a favorable outcome if diagnosed and treated early.
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Affiliation(s)
- M K Lyons
- Department of Neurologic Surgery, Mayo Clinic Scottsdale, Arizona 85259, USA
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35
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O'Neill BP, O'Fallon JR, Earle JD, Colgan JP, Brown LD, Krigel RL. Primary central nervous system non-Hodgkin's lymphoma: survival advantages with combined initial therapy? Int J Radiat Oncol Biol Phys 1995; 33:663-73. [PMID: 7558957 DOI: 10.1016/0360-3016(95)00207-f] [Citation(s) in RCA: 116] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
PURPOSE Results of multiple radiation, chemotherapy, and combined treatment trials have shown that the fate of primary central nervous system lymphoma (PCNSL) patients is very different from that of patients with similarly treated systemic IE non-Hodgkin's lymphoma. This study was designed to improve the survival of PCNSL patients by the use of combined initial therapy. METHODS AND MATERIALS Forty-six eligible primary PCNSL patients were treated with whole brain irradiation and adjuvant chemotherapy consisting of preirradiation cyclophosphamide-adriamycin-vincristine-prednisone (CHOP) and postirradiation high-dose cytosine arabinoside (HDAC) as part of an ongoing Phase II Mayo/North Central Cancer Treatment Group/Eastern Cooperative Oncology Group (M/NCCTG/ECOG) intergroup effort, which opened in April 1986. RESULTS This cohort consisted of 23 men and 23 women with median age 63.5 years (range 24 to 75 years). Only 5% were under age 40; 36% were age 40 to 59, 37% were age 60 to 69, and 22% were age 70 and over. Forty-six percent had good performance scores of ECOG 0-1 at time of study entry. Forty-six patients were evaluable for treatment outcome as of October 6, 1993. Of these, 10 were still alive. Estimated median survival and 21-month survival were 45.3 weeks and 29%, respectively. There were four early deaths ranging from Day 9 to Day 15 (three drug-related, one from other complications), and two CHOP responders died at 32 and 35 days, soon after Cycle 2 of CHOP (one probably drug-related, one from other complications). There was no significant difference in survival according to baseline performance status. However, survival was consistently worse for patients > 60 years old than for the younger patients (< or = 60 years). With deaths recorded for 21 of 21 older patients, but only 9 of the 14 younger patients, 21-month survival for older vs. younger was 14 vs. 50% based on the 35 patients who entered the study at least 21 months ago (p = 0.0365). Of the 46 patients evaluable for response, 63% had objective remissions on CHOP and another 20% remained stable. CONCLUSION Combined modality therapy in this study did not produce an overall survival advantage in treating PCNSL. The 50% 21-month survival of younger patients may be a reflection of age only.
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Affiliation(s)
- B P O'Neill
- Department of Neurology, Mayo Clinic/Foundation, Rochester, MN 55905, USA
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Tomlinson FH, Kurtin PJ, Suman VJ, Scheithauer BW, O'Fallon JR, Kelly PJ, Jack CR, O'Neill BP. Primary intracerebral malignant lymphoma: a clinicopathological study of 89 patients. J Neurosurg 1995; 82:558-66. [PMID: 7897514 DOI: 10.3171/jns.1995.82.4.0558] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The authors report on a clinicopathological study of 89 surgical patients with histologically proven primary parenchymal brain lymphoma, all diagnosed between January 1975 and December 1990. The cohort included 60 men and 29 women whose median age at diagnosis was 60 years (range 14 to 84 years). The duration of symptoms was less than 8 weeks in 48% of the patients. Symptom groups included focal neurological deficit (73%), neuropsychiatric symptoms (28%), seizures (9%), and increased intracranial pressure (3%). A total of 132 tumors were seen in 89 patients: the most common sites were frontal (32 patients), temporoparietal (31 patients), and basal ganglia (17 patients); multiple lesions were reported in 23 patients. No patient had antecedent of human immunodeficiency virus positivity or acquired immunodeficiency syndrome. A family history of cancer was present in 33% of the patients, three-quarters of whom were first-degree relatives. Histological subtypes (National Cancer Institute Working Formulation) included 64 large cell (72%) and 13 immunoblastic (15%) tumors. Phenotype was determined in 66 patients: 63 were B-cell type and three were T-cell type. Surgical resection was performed in 47% of the cases, with the remainder undergoing biopsy only. All but six patients received radiation therapy. Thirty-one patients received chemotherapy, whereas 46 patients did not; data on the remaining 12 patients were unavailable. The end point of the study was death from any cause. At the time of last contact, 69 of the patients (78%) had died; the median survival time for this study group was 20.9 months. On univariate analysis, prognostic factors significantly associated with survival included age at diagnosis, family history of cancer, and focal neurological deficit. Multivariate analysis revealed four unfavorable prognostic factors: age greater than or equal to 60 years, history of cancer in first-degree relatives, focal deficit, and ependymal contact. After adjustment for these variables, clinical syndrome, size and number of lesions, extent of surgery, histological cell type, radiation dose, and use of chemotherapy were not significantly associated with survival.
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Affiliation(s)
- F H Tomlinson
- Department of Neurological Surgery, Mayo Clinic and Foundation, Rochester, Minnesota
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O'Neill BP, Dinapoli RP, Kurtin PJ, Habermann TM. Occult systemic non-Hodgkin's lymphoma (NHL) in patients initially diagnosed as primary central nervous system lymphoma (PCNSL): how much staging is enough? J Neurooncol 1995; 25:67-71. [PMID: 8523091 DOI: 10.1007/bf01054724] [Citation(s) in RCA: 81] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To demonstrate the extent of staging necessary to exclude occult systemic stage IV NHL before making a diagnosis of stage I AE PCNSL. BACKGROUND The diagnosis of PCNSL requires the demonstration of malignant lymphocytes within the CNS (usually by biopsy) and finding no evidence of systemic NHL. Different staging approaches have been recommended, ranging from extensive systemic evaluation (including bone marrow examination) to a more focused approach (abdominal and pelvic CT) to no systemic evaluation. We have employed a staging regimen that included: ophthalmologic evaluation (including slit lamp examination); CT of chest, abdomen, and pelvis; bilateral iliac crest aspirate and biopsy; flow cytometry of circulating lymphocytes; and, in men, testicular ultrasound. DESIGN/METHODS We carried out a retrospective review of 128 patients entered into the Mayo Lymphoma Project data bank (1975-1994). RESULTS Between the years 1975 and 1994, five patients (3.9%) were identified who fulfilled criteria for the diagnosis of PCNSL (typical clinical history, pathognomonic neuro-imaging, and histologic proof of NHL in brain tissue) but who had occult systemic NHL on staging (bone marrow 1, abdominal lymph nodes 3), or at autopsy (colon 1). Case histories are presented. CONCLUSIONS Patients with apparent PCNSL may have systemic NHL. Complete staging is essential to the initial management of patients presenting as PCNSL to exclude systemic stage IV disease.
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Affiliation(s)
- B P O'Neill
- Department of Neurology, Mayo Clinic and Foundation, Rochester, MN 55905, USA
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Abstract
OBJECTIVE To describe current concepts in the diagnosis and treatment of brain metastases. RESULTS More than 25% of all autopsy-proven brain metastases have a pulmonary source. Most brain metastases manifest with a combination of focal and generalized symptoms and signs. Typically, patients have subacute, progressive symptoms. In most situations, a computed tomographic scan of the head provides sufficient neuroimaging and allows one to monitor the effects of therapy. Magnetic resonance imaging has become increasingly useful in the diagnosis and management of brain metastases. It can detect computed tomographic occult metastases, identify associated leptomeningeal disease, and reveal early therapeutic complications. CONCLUSION Treatment options for patients with brain metastases include corticosteroids, whole-brain radiation therapy (WBRT), surgical intervention, stereotactic radiosurgical techniques, and chemotherapy. Corticosteroids produce prompt improvement in most patients; however, prolonged use is associated with considerable risks. For most patients, WBRT is the preferred treatment. Nonetheless, it has associated nonneurologic and neurologic complications, some of which are serious. In patients with a single metastasis, surgical removal should be considered. Recent studies have suggested that resection of a single metastatic lesion followed by radiation therapy offers better survival than does radiation therapy alone. The subsequent administration of WBRT after radiosurgical treatment has become standard practice. The role of chemotherapy is uncertain.
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Affiliation(s)
- B P O'Neill
- Department of Neurology, Mayo Clinic Rochester, Minnesota 55905
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Abstract
To determine the frequency and pattern of neurological complications of T-cell lymphoma (TCL), we retrospectively reviewed the medical records of 316 patients with TCL diagnosed between January 1984 and May 1991. Disease entities not included in this study were lymphoblastic lymphoma, primary central nervous system lymphoma, CD30-positive anaplastic large cell lymphoma, and lymphomas secondary to human immunodeficiency virus or human T-cell lymphotropic virus type I. Cases were classified as having direct complications (parenchymal, leptomeningeal, epidural, or peripheral) or indirect complications (paraneoplastic, disease related, or treatment related). Preexisting neurological conditions were excluded. The overall rate of neurological complications was 7.9%. The frequency of neurological complications in peripheral TCL and cutaneous TCL was 17% and 3%, respectively, with at least half of the neurological complications in both conditions due to direct involvement of the nervous system. Direct neurological complications of TCL were primarily due to leptomeningeal and parenchymal involvement. There were no cases of epidural spinal cord disease.
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Affiliation(s)
- D K Kaufman
- Department of Neurology, Mayo Clinic, Rochester, MN 55905
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Abstract
Meningeal and cortical biopsies were evaluated in 37 patients (25 men and 12 women; mean age, 54 yr) who had chronic meningitis of an unknown cause between 1985 and 1993 (the era of magnetic resonance imaging). Magnetic resonance imaging with gadolinium contrast was the most useful diagnostic imaging technique, demonstrating meningeal enhancement in 15 of 32 patients (47%). Only 2 of 32 (6%) computed tomographic scans revealed enhancement. A definitive diagnosis was made in 16 of 41 biopsies (39%), but in cases where enhancement was present on either magnetic resonance imaging or computed tomography, a diagnosis was obtained in 80% (12 of 15 cases). Only 2 of 22 biopsies (9%) from nonenhancing regions were diagnostic. Although the locations of enhancement were distributed evenly, biopsies through suboccipital and pterional craniotomies gave the highest diagnostic yields (50%). Furthermore, if the biopsies were obtained from enhancing regions, the yield of these two approaches increased to 84 and 100%, respectively. Of 18 cases in which biopsy samples were taken from both the meninges and cortex, only 1 had cortical involvement alone. The meninges were therefore diagnostic in 15 of the 16 definitive diagnostic cases (94%). Second biopsies were necessary in four cases, of which the three biopsies from enhancing regions were diagnostic. The most frequent causes of chronic meningitis were sarcoid (31%) and metastatic adenocarcinoma (25%).(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- T M Cheng
- Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota
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41
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Derlon JM, Petit-taboué MC, Dauphin F, Courtheoux P, Chapon F, Creissard P, Darcel F, Houtteville JP, Kaschten B, Sadzot B, Stevenaert A, Tjuvajev JG, Macapinlac HA, Daghighian F, Ginos JZ, Finn RD, Jiaju Zhang MS, Beattie B, Graham M, Larson SM, Blasberg RG, Levivier M, Goldman S, Pirotte B, Brucher JM, Balériaux D, Luxen A, Hildebrand J, Brotchi J, Go KG, Kamman RL, Mooyaart EL, Heesters MAAM, Sijens PE, Oudksrk M, van Dijk P, Levendag PC, Vecht CJ, Metz RJ, Kennedy DN, Rosen BR, Hochberg FH, Fishman AJ, Filipek PA, Caviness VS, Gross MW, Weinzierl FX, Trappe AE, Goebel WE, Frank AM, Becker G, Krone A, Schmidt K, Hofmann E, Bogdahn U, Bencsch H, Fclber S, Finkenstedt G, Kremser C, Sfockhammer G, Aichner F, Bogdahn U, Fröhlich T, Becker G, Krone A, Schlief R, Schürmann J, Jachimczak P, Hofmann E, Roggendorf W, Roosen K, Carapella CM, Carpinelli G, Passalacqua R, Raus L, Giannini M, Mastrostefano R, Podo F, Tofani A, Maslrostefano R, Mottoles M, Ferraironi A, Scelsa MG, Oppido P, Riccio A, Maini CL, Collombier L, Taillandier L, Dcbouverie M, Laurens MH, Thouvenot P, Weber M, Bertrand A, Cruickshank GS, Patterson J, Hadley D, De Witte O, Hildebrand J, Luxen A, Goldman S, Reifenberger J, Liu L, James CD, Wechsler W, Collins VP, Fabel-Schulte K, Jachimczak P, Heßdörfer B, Baur I, Schlingensiepen KH, Ernestus RI, Brysch W, Bogdahn U, Blesch A, Bosserhoff AK, Apfel R, Lottspeich F, Jachimczak P, Büttner R, Bogdahn U, Cece R, Bockhorst K, Barajon I, Tazzari S, Cavaletti G, Torri-Tarelli L, Tredici G, Hecht B, Turc-Carel C, Atllas R, Chatel M, Gaudray P, Eis M, Gioanni J, Hecht F, Balledux J, Rothbart D, Criscuolo GR, de Campos JM, Kusak ME, Rey JA, Bello MJ, Sarasa JL, Els T, Dubois F, Blond S, Parent M, Assaker R, Gosselin P, Christiaens JL, Feld R, Moringlane JR, Steudel WI, Schaudies JR, Hoehn-Berlage M, Janka M, Tonn JC, Fischer U, Meese E, Roosen K, Remmelink M, Salmon I, Cras P, Pasteels JL, Brotchi J, Gliese M, Kiss R, Bensadoun RJ, Frenay M, Formento JL, Milano G, Lagrange JL, Grellier P, Lee JY, Ernestus RI, Riese HH, Fründ R, Cervós-Navarro J, Reutter W, Lippitz B, Scheitinger C, Scholz M, Weis J, Gilsbach JM, Füzesi L, Koochekpour S, Merzak A, Geissler A, Pilkington GJ, Sanson M, Li YJ, Hoang-Xuan K, Delattre JY, Poisson M, Hamelin R, Van de Kelft E, Dams E, Martin JJ, Woertgen C, Willems P, Lehrke R, Voges J, Treuer H, Erdmann J, Müller RP, Sturm V, Wurm RE, Warrington AP, Laing RW, Holzschuh M, Sardell S, Hines F, Graham JD, Brada M, Ushio Y, Kuratsu JI, Kochi M, Kitz K, Aichholzer M, Rössler K, Goldman S, Alesch F, Ertl A, Sorensen PS, Helweg-Larsen S, Mourldsen H, Hansen HH, El Sharoum SY, Berfelo MW, Theunissen PHMH, Jager JJ, Levivier M, de Jong JMA, Fedorcsák I, Nyáry I, Osztie É, Horvath Á, Kontra G, Frenay M, Burgoni-chuzel J, Paquis P, Lagrange JL, Pirotte B, Helweg-Larsen S, Hansen SW, Sørensen PS, Salmon I, Kiss R, Krauseneck P, Müller B, Morche M, Tonn JC, Lagerwaard FJ, Brucher JM, Levendag PC, Eijkenboom WMH, Schmilz PIM, Lentzsch S, Weber F, Franke J, Dörken B, Lunardi P, Schettini G, Osman FJ, Luxen A, Qasho R, Mocellini C, Ruda R, Soffietti R, Garabello D, Sales S, De Lucchi R, Vasario E, Schiffer D, Muracciole X, Brotchi J, Régis J, Manera L, Peragut JC, Juin P, Sedan R, Nieder C, Niewald M, Walter K, Schnabel K, Nieder C, Hildebrand J, Niewald N, Nestle U, Schnabel K, Berberich W, Oschmann P, Theißen RD, Reuner KH, Kaps M, Dorndorf W, Martin KK, Hausmann O, Akinwunmi J, Rooprai HK, Kennedy A, Linke A, Ognjenovic N, Pilkington GJ, Svadovsky AI, Peresedov VV, Bulakov AA, Butyalko MY, Merlo A, Zhirnova IG, Labunsky DA, Gnazdizky VV, Gannushkina IV, Taphoorn MJB, Potman R, Barkhof F, Weerts JG, Karim ABMF, Heimans JJ, Jerrnann E, van de Pol M, van Aalst VC, Wilmink JT, Twijnstra A, van der Sande JJ, Boogerd W, Kröger R, Jäger A, Wismeth C, Dekant A, Uirich J, Brysch W, Schlingensiepen KH, Jachimczak P, Bogdahn U, Pirolte B, Cool V, Gérard C, Levivier M, Dargent JL, Goldman S, Chiquet-Ehrismann R, Brotchi J, Hildebrand J, Velu T, Herrlinger U, Schabet M, Ohneseit P, Buchholz R, Zhu J, Reszka R, Weber F, Müller J, Walther W, Zhang LI, Brock M, Roosen N, Rock JP, Zeng H, Feng J, Fenstermacher JD, Rosenblum ML, Siegal T, Mäcke H, Gabizon A, Beljanski M, Crochet S, Bergenheim AT, Zackrisson B, Elfverson J, Bergström P, Henriksson R, Butti G, Baetta R, Gratzl O, Magrassi L, De Renzis MR, Soma MR, Davegna C, Pezzotta S, Paoletti R, Fumagalli R, Infuso L, Sankar AA, Darling JL, Herholz K, Thomas DGT, Defer GL, Brugières P, Gray F, Chomienne C, Poirier J, Degos L, Degos JD, Colombo BM, DiDonato S, Ghaemi M, Finocchiaro G, Hebeda KM, Sterenborg HJCM, Saarnak AE, Wolbers JG, van Gemert MJC, Kaaijk P, Troost D, Leenstra S, Das PK, Würker M, Bosch DA, Kostron H, Hochleitner BW, Obwegeser A, Ortler M, Seiwald M, Vooys W, Krouwer HGJ, de Gast GC, Marx JJM, Pietrzyk U, Osman FJ, Lunardi P, Puzzilli F, Menovsky T, Beek JF, Wolbers JG, van Gemert MJC, Naujocks G, Wiestler OD, Schirrmacher V, Heiss WD, Schramm J, Schmitz A, Eis-Hübinger AM, Piepmeier PH, Pedersen P, Greer C, Quigley MR, Shih T, Elrifal A, Rothfus W, Kotitschke K, Maroon JC, Rohertson L, Rampling R, Whoteley TL, Piumb JA, Kerr DJ, Falina PA, Crossan IM, Roosen N, Rock JP, Brandl M, Feng J, Zeng H, Ho KL, Fenstermacher JD, Rosenblum ML, Ruchoux MM, Vincent S, Jonca F, Plouet J, Lecomte M, Tonn JC, Samid D, Thibault A, Ram Z, Oldfield EH, Myers CE, Reed E, Schabet M, Herrlinger U, Buchholz R, Shoshan Y, Haase A, Siegal T, Siegal T, Shezen E, Siegal T, Stockhammer G, Rosenblum M, Samid D, Lieberman F, Terzis AJA, Bjerkvig R, Bogdahn U, Laerum OD, Arnold H, Thibault A, Samid D, Figg WD, Myers CE, Reed E, Thomas R, Flux G, Chittenden S, Kotitschke K, Doshi P, Brazil L, Thomas DGT, Bignor D, Zalutsky M, Brada M, Tjuvajev J, Kaplitt M, Desai R, Bradley MS, Muigg S, Bettie BS, Gansbacher B, Blasberg R, Haugland HK, Saraste J, Rooseni K, Laerum OD, Vincent AJPE, Avezaat CJJ, Bout A, Felber S, Noteboom JL, Vecht CH, Valerio D, Hoogerbrugge PM, Weber F, Reszka R, Zhu J, Walther W, List J, Schulz W, Aichner F, Wolbers JG, Sterenborg IIJCM, Kamphorst W, van Gemert MJC, van Alplien HAM, Salander P, Bergenheim T, Henriksson R, Grant R, Brazil L, Haase A, Thomas R, Guerrero D, Laing R, Ashley S, Brada M, Schmidt B, Bauer B, Grau G, Bohnstedt T, Frydrych A, Bogdahn U, Franz K, Lorenz R, Brandes A, Amanzo PD, Zampieri P, Rigon A, Scelzi E, Rotilio A, Berti F, Paccagnella A, Krone A, Fiorentino MV, Müller B, Krauseneck P, van Deventer PL, Dellemijn PLI, van den Bent MJ, Vecht CJ, Kansen PJ, Tredici G, Petruccioli NG, Becker G, Cavaletti G, Cavalletti E, Kiburg B, Müller LJ, Moorer-van Delft CM, Heimans JJ, Boer HH, Pace A, Bove L, Pietrangeli A, Woydt M, Innocenti P, Aloe A, Nardi M, Jandolo B, Kellie SJ, De Graaf SSN, Bloemhof H, Roebuck D, Dalla PL, Uges DDR, Roggendorf W, Johnston I, Besser M, Chaseling RA, Koeppen S, Gründemann S, Lossos A, Siegal T, Nitschke M, Vieregge P, Reusche E, Hofmann E, Rob P, Kömpf D, Postma TJ, Vermorken JB, Heimans JJ, Rampling RP, Dunlop DJ, Steward MS, Campbell SM, Roy S, Bogdahn U, Hilkens PHE, Verweij J, van Putten WLJ, Vecht CJ, van den Bent MJ, Hilkens PHE, Moll JWB, van der Burg MEL, Planting AST, van Putten WLJ, Roosen K, Vecht CJ, van den Bent MJ, Wondrusch E, Zifko U, Drlicek M, Liszka U, Grisold W, Zifko U, Fazeny B, Dittrich C, Lanfermann H, Wondrusch E, Grisold W, Verschuuren JJ, Meneses PI, Rosenfeld MR, Kaplitt MG, Posner JB, Dalmau J, Sillevis Smitt PAE, Manley G, Heindel W, Posner JB, Cavaletti G, Bogliun G, Margorati L, Bianchi G, Drlicek M, Liska U, Casati B, Kolig C, Grisold H, Kugel H, Graus F, Reñe R, Uchuya M, Valldeoriola F, Delattre JY, Benedetti de Cosentiro C, Ortale D, Martinez R, Lambre J, Cagnolati S, Erneslus RI, Vinai C, Salmaggi A, Nemni R, Silvani A, Forno MG, Luksch R, Confalonieri P, Boiardi A, Nitschke M, Scholz J, Röhn G, Vieregge P, Kömpf D, Hochberg FH, Pfeiffer G, Netzer J, Hansen C, Eggers C, Hagel C, Kunze K, Verschuuren JJ, Lackner K, Rosenblum MK, Lieberman FS, Posner JB, Dalmau J, Metz RJ, Kennedy DN, Pardo FS, Kutke S, Sorensen AG, Hochberg FH, Fishman AJ, Filipek PA, Rosen BR, Caviness VS, Mechtler LL, Withiam-Lench S, Shin K, Klnkel WR, Patel M, Truax B, Kinkel P, Shin K, Mechtler L, Ricci M, Pantano P, Maleci A, Pierallini S, Di Stefano D, Bozzao L, Cantore GP, Röhn G, Els T, Schröder R, Hoehn-Berlage M, Ernestus RI, Ruda R, Mocellini C, Soffietti R, Campana M, Ropolo R, Riva A, de Filippi PG, Schiffer D, Salgado D, Rodrigues M, Salgado L, Fonseca AT, Vieira MR, Bravo Marques JM, Satoh H, Uozumi T, Kiya K, Kurisu K, Arita K, Sumida M, Ikawa F, Tzuk-Shina T, Gomori JM, Rubinstein R, Lossos A, Siegal T, Vaalburg W, Paans AMJ, Willemsen ATM, van Waarde A, Pruim J, Visser GM, Go KG, Valentini S, Ting YLT, De Rose R, Chidichimo G, Corricro G, van Lcycn-Pilgram K, Erncslus RI, Klug N, van Leyen-Pilgram K, Ernestus RI, Schröder R, Klug N, Woydt M, Krone A, Tonn JC, Becker G, Neumann U, Roggendorf W, Roosen K, Plate KH, Breier G, Millaucr B, Weich HA, Ullrich A, Risau W, Roosen N, Chopra RK, Mikkelsen T, Rosenblum SD, Yan PS, Knight R, Windham J, Rosenblum ML, Schiffer D, Attanasio A, Cavalla P, Chio A, Giordana MT, Migheli A, Amberger V, Hensel T, Schwab ME, Cervoni L, Celli P, Tarantino R, Huettner C, Tonn JC, Berweiler U, Roggendorf W, Salmon I, Rorive S, Rombaut K, Pirotte B, Haot J, Brotchi J, Kiss R, Maugard-Louboutin C, Charrier J, Fayet G, Sagan C, Cuillioere P, Ricolleau G, Martin S, Menegalli-Bogeelli D, Lajat Y, Resche F, Molnàr P, Bárdos H, Ádány R, Rogers JP, Pilkington GJ, Pollo B, Giaccone G, Allegranza A, Bugiani O, Prim J, Badia J, Ribas E, Coello F, Shezen E, Lossos A, Abramsky O, Siegal T, Scerrati M, Roselli R, Iacoangeli M, Pompucci A, Rossi GF, Deeb SMA, Koreich O, Yaqub B, Moutaery KRA, Giordana MT, Cavalla P, Chio A, Marino S, Vigliani MC, Schiffer D, Deburghgraeve V, Darcel F, Gedouin D, Hassel MB, Guegan Y, Jeremic B, Grujicic D, Antunovic V, Matovic M, Shibamoto Y, Kallio M, Huhmar H, Kudoh C, Detta A, Sugiura K, Hitchcock ER, Mastrostefano R, Di Russo R, Cipriani§ M, Occhipinti EM, Conti EMS, Clowegeser A, Ortler M, Seiwald M, Kostron H, Rajan B, Ross G, Lim C, Ashlcy S, Goode D, Traish D, Brada M, Sanden GACV, Schouten LJ, Coebergh JWW, Razenberg PPA, Twijnstra A, Snilders-Keilholz A, Voormolen JHC, Hermans J, Leer JWH, Taillandier L, Baylac F, Dcbouvcrie M, Anxionnal R, Bracard S, Vignand JM, Duprcz A, Weber M, Winking M, Böker DK, Simmet T, Rothbart D, Strugar J, Balledux J, Criscuolo GR, Jachimczak P, Blesch A, Heβdörfer B, Bogdahn U, Ernestus RI, Schröder R, Klug N, Krouwer HGJ, Duinen SGV, Algra A, Zentner J, Wolf HK, Ostertun B, Hufnagel A, Campos MG, Solymosi L, Schramm J, Newlands ES, O'Reilly SM, Brampton M, Soffietti R, Chio A, Mocellini C, Ruda R, Vigliani MC, Schiffer D, Sciolla R, Seliak D, Henriksson R, Bergenheim AT, Björk P, Gunnarsson PO, Hariz M, Grant R, Collie D, Gregor A, Ebmeier KP, Jarvis G, Lander F, Cull A, Sellar R, Brada M, Thomas C, Elyan S, Hines F, Ashley S, Stenning S, Bernstein JJ, Goldberg WJ, Roelcke U, Von Ammon K, Hausmann O, Radu EW, Kaech D, Leenders KL, Fitzek MM, Aronen JE, Hochberg F, Gruber M, Schmidt E, Rosen B, Flschman A, Pardo P, Afra UMU, Sipos L, Slouik F, Boiardi A, Salmaggi A, Pozzi A, Farinotti L, Fariselli L, Silvani A, Brandes A, Scelzi E, Rigon A, Zampieri P, Pignataro M, Amanzo PD, Amista P, Rotilio A, Fiorentino MV, Thomas R, Brazil L, O'Connor AM, Ashley S, Brada M, Salvati M, Cervoni L, Puzzilli F, Cervoni L, Salvati M, Raguso M, Cruickshank GS, Duckworth R, Rumpling R, Rottuci M, Fariselli L, Boiardi A, Broggi G, Plrint NG, Sabattini E, Manetto V, Gambacorta H, Poggi S, Pileri S, Ferracini R, Grant R, Plev DV, Hopf NJ, Knosp E, Bohl J, Perncczky A, Kiss R, Salmon I, Catnby I, Dewitte O, Brotchi J, Pasteels JL, Camby I, Salmon I, Darro F, Danguy A, Brotchi J, Pasteels JL, Kiss R, Kiu MC, Lai GM, Yang TS, Ng KT, Chen JS, Chang CN, Leung WM, Ho YS, Rychter MD, Klimek A, Liberski PP, Karpinaka A, Krauseneck P, Schöffel V, Müller B, Kreth FW, Faist M, Warnke PC, Ostertag CB, Nielen KMBV, Visscr MC, Lebrun C, Lonjon M, Desjardin T, Michiels JF, Chanalet SLJL, Roche JL, Chatel M, Mastronardi L, Puzzilli F, Osman FJ, Lunardi P, Matsutani M, Ushio Y, Takakura K, Menten J, Hamers H, Ribot J, Dom R, Tcepen H, Müller B, Weidner N, Krauseneck P, Naujocks G, van Roost D, Wiestler OD, Kuncz A, Nieder C, Setzel-Sesterhein M, Niewald M, Schnabel I, O'Neill KS, Kitchen ND, Wilkins PR, Marsh HT, Pierce E, Doshi R, Deane R, Previtali S, Quattrini A, Nemni R, Ducati A, Wrabetz L, Canal N, Punt CJA, Stamatakis L, Giroux B, Rutten E, Quigley MR, Beth Sargent PAC, Flores N, Simon S, Maroon JC, Quigley MR, Beth Sargent PAC, Flores N, Maroon JC, Rocca AA, Gervasoni C, Castagna A, Picozzi P, Giugni E, Rocca AA, Tonnarelli GP, Ducati A, Mangili F, Truci G, Canal N, Giovanelli M, Roelcke U, Von Ammon K, Radu EW, Leenders KL, Sachsenheimer W, Bimmler T, Seiwald M, Eiter HRW, Ortler M, Obwegesser A, Kostron H, Steilen H, Henn W, Moringlane JR, Kolles H, Feiden W, Zang KD, Sleudel WI, Steinbrecher A, Schabet M, Heb C, Bamberg M, Dichgans J, Stragliotto G, Delattre JY, Poisson M, Zampieri P, Brandes A, Rigon A, Tosatto L, D'Amanzo P, Menicucci N, Rotilio A, Mingrino S, Steudel WI, Feld R, Henn W, Zang KD, Maire JP, Caudry M, Guerin J, Celerier D, Salem N, Demeaux H, Fahregat JF, Kusak ME, Bucno A, Albisua J, Jerez P, Sarasa JL, Garefa R, de Campos JM, Kusak ME, de Campos JM, Bueno A, García-Delgado R, Sarasa JL, García-Sola R, Lantsov AA, Shustova TI, Lcnartz D, Wellenreuther R, von Deirnling A, Köning W, Menzel J, Scarpa S, Manna A, Reale MG, Oppido PA, Carapella CM, Frati L, Valery CA, Ichen M, Foncin JP, Soubrane C, Khayat D, Philippon J, Vaz R, Cruz C, Weis S, Protopapa D, März R, Winkler PA, Reulen HJ, Bise K, Beuls E, Berg J, Deinsberger W, Böker DK, Samii M, Caudry M, Darrouzet V, Guérin J, Trouette R, Causse N, Bébéar JP, Parker F, Vallee JN, Carlier R, Zerah M, Lacroix-Jousselin C, Piepmeier JM, Kveton J, Czibulka A, Tigliev GS, Chernov MP, Maslova LN, Valdueza JM, Jänisch W, Bock A, Harms L, Bessell EM, Graus F, Punt J, Firth J, Hope T, Koriech O, Al Deeb S, Al Moutaery K, Yaqub B, Silvani A, Salmaggi A, Pozzi A, Franzini A, Boiardi A, Goldbrunner R, Warmuth-Metz M, Paulus W, Tonn JC, Roosen K, Strik II, Müller B, Markert C, Pflughaupt KW, Krauseneck P, O'Neill BP, Dinapoli RP, Voges J, Sturm V, Deuß U, Traud C, Treuer H, Lehrke R, Kim DG, Müller RP, Alexandrov YS, Moutaery K, Aabed M, Koreich O, Ross GM, Rajan B, Traish D, Ashley S, Ford D, Brada M, Schmeets ILO, Jager JJ, Pannebakker MAG, de Jong JMA, van Lindert E, Knosp E, Kitz K, Blond S, Dubois F, Assaker R, Baranzelli MC, Sleiman M, Pruvo JP, Coche-Dequeant B, Matsutani M, Takakura K, Sano K, PetriČ-Grabnar G, Jereb B, Župančič N, Koršič M, Rainov NG, Burkert W, Ushio Y, Kochi M, Itoyama Y, de Campos JM, Kusak ME, Sarasa JL, García R, Bueno A, Ferrando L, Hoang-Xuan K, Sanson M, Merel P, Delattre JY, Poisson M, Delattre O, Thomas G, Hoang-Xuan K, Delattre JY, Poisson M, Thomas G, Haritz D, Obersen B, Grochulla F, Gabel D, Haselsberger K, Radner H, Pendl G, Brada M, Laing RW, Warrington AP, Nowak PJCM, Kolkman-Deurloo IKK, Visser AG, Berge HD, Niël CGJH, Levendag PC, Bergström P, Hariz M, Löfroth PO, Bergenheim T, Henriksson R, Blond S, Assaker R, Cortet-rudelli C, Dewailly D, Coche-dequeant B, Castelain B, Dinapoli R, Shaw E, Coffey R, Earle J, Foote R, Schomberg P, Gorman D, Girard N, Courel MN, Delpech B, Haselsberger K, Friehs GM, Schröttner O, Pendl G, Pötter R, hawliczek R, Sperveslage P, Prott FJ, Wachter S, Dieckmann K, Würker M, Herholz K, Pietrzyk U, Voges J, Treuer H, Sturm V, Bauer B, Heiss WD, Jund R, Zimmermann F, Feldmann HJ, Gross MW, Kneschaurek P, Molls M, Lederman G, Lowry J, Wertheim S, Voulsinas L, Fine M, Lederman G, Lowry J, Wertheim S, Fine M, Voutsinas I, Qian G, Rashid H, Lederman G, Lowry J, Wertheim S, Fine M, Voulsinas L, Qian G, Rashid H, Moutaery K, Aabed M, Koreich O, Scerrati M, Montemaggi P, Iacoangeli M, Pompucci A, Roselli R, Trignani R, Rossi GF, Shin K, Mechtler L, West C, Grand W, Shin K, Sibata C, West C, Mechtler L, Grand W, Thomas R, Guerrero D, James N, Ashley S, Gregor A, Brada M, Voges J, Sturm V, Bramer R, Pahlke H, Lehrke R, Treuer H, Banik N, Kim DG, Hövels M, Bernsen HJJA, Rijken PFJW, Van der Sanden BPJ, Hagemeier NEM, Van der Kogel AJ, Koehler PJ, Verbiest H, Jager J, Vecht CJ, Ross GM, McIlwrath A, Brown R, Mottolesb C, Pierre'Kahn A, Croux M, Roche JL, Marchai J, Delhemes P, Tremoulet M, Stilhart B, Chazai J, Caillaud P, Ravon R, Passacha J, Bouffet E, Dirven CMF, Mooy JJA, Molenaar WM, Lewandowicz GM, Grant N, Harkness W, Hayward R, Thomas DGT, Darling JL, Delepine N, Subovici II, Cornille B, Markowska S, Alkallaf JCD, KühI J, Niethammer D, Spaar HJ, Gnekow A, Havers W, Berthold F, Graf N, Lampert F, Maass E, Mertens R, Schöck V, Aguzzi A, Boukhny A, Smirtukov S, Prityko A, Hoiodov B, Geludkova O, Nikanorov A, Levin P, Rothbart D, Balledux J, Criscuolo GR, D'haen B, Van Calenbergh F, Casaer P, Dom R, Menten J, Goffin J, Plets C, Hertel A, Hernaiz P, Seipp C, Siegler K, Baum RP, Maul FD, Schwabe D, Jacobi G, Kornhuber B, Hör G, Menten J, Casaer P, Pilkington GJ, Merzak A, Rooprai HK, Bullock P, van Domburg PHMF, Wesseling P, Thijssen HOM, Wolff JEA, Boos J, Krähling KH, Gressner-Brocks V, Jürgens H, Schlegel J, Scherthan H, Arens N, Stumm G, Kiessling M, Merzak A, Koochekpour S, Pilkington GJ, Reifenberger G. Abstracts. J Neurooncol 1994. [DOI: 10.1007/bf01070874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
Primary lymphomas of the CNS are rare. However the incidence of these lesions has increased recently. These tumors are often situated in the thalamus and basal ganglia, but can be multifocal. The treatment for primary CNS lymphoma is radiotherapy alone or in association with chemotherapy. Because the associated morbidity is very low stereotactic biopsy is an ideal method for determining the histologic diagnosis in patients with suspected CNS lymphoma. The authors present a study of 49 patients with primary CNS lymphomas in which a stereotactic biopsy was performed.
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Affiliation(s)
- M S Meneses
- Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota
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Abstract
Eight patients treated for histologically confirmed primary spinal epidural non-Hodgkin's lymphoma diagnosed between January 1979 and August 1989 (6.6% of all cases of intraspinal lymphoma) were studied. There were six men and two women. The median age was 70 years (range, 43-80 yr). Patients sought treatment for a prodrome of back pain (median duration, 3 mo) followed by an acute neurological deterioration (median duration, 6 d). The most common findings were a discrete sensory level in 5 patients, hyperreflexia in 5 patients, and paraparesis or paraplegia in 5 patients. Radiographically, there was an absence of bony destruction by these tumors. All patients underwent a decompressive laminectomy, subtotal tumor resection, and spinal irradiation (median dose, 3800 cGy). Two patients had low-grade lymphomas (one B cell and one T cell), and 6 patients had intermediate-grade lesions (six B cell). Two patients with B-cell lymphomas (one low-grade and one intermediate-grade) developed metastatic disease 15 and 17 months after the initial diagnosis; no evidence of lymphoma developed in the other 6 patients. The median survival was 22 months (range, 2-71 mo). Lymphoma was the cause of death in only 1 of the 4 patients who died, and the 4 younger patients are alive and well. Primary spinal epidural non-Hodgkin's lymphoma should be a diagnostic consideration in the older patient who seeks treatment for spinal cord compression manifested by a prodrome of back pain, followed by a rapid neurological deterioration, normal plain spine radiographs, and neuroimaging consistent with an extradural compressive lesion. Surgery for this diagnosis followed by spinal irradiation should result in significant neurological improvement.
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Affiliation(s)
- M K Lyons
- Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota
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Abstract
Two patients who had focal neurological deficits as the initial manifestation of a malignant non-Hodgkin's lymphoma involving the skull are described. Soft-tissue masses and variable bone destruction were the predominant computed tomographic findings, and magnetic resonance imaging studies revealed meningeal involvement in one case and sinus thrombosis in the other. Malignant non-Hodgkin's lymphomas initially appearing in the skull are rare, but these lesions should be considered in patients with a palpable scalp mass who have focal neurological signs.
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Affiliation(s)
- G K Herkes
- Department of Neurology, Mayo Graduate School, Rochester, Minnesota
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45
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Abstract
A 28-year-old man had a 5-month history of focal and generalized neurologic symptoms culminating in a thoracic myelopathy. Evaluation revealed granulomatous angiitis of the spinal cord in association with occult nodular sclerosing Hodgkin's disease. In previous reports, manifestations indicative of intracranial involvement have dominated the clinical presentation of granulomatous angiitis associated with Hodgkin's disease. Successful therapy for Hodgkin's disease may result in marked improvement of associated granulomatous angiitis, whereas the lack or failure of therapy results in a uniformly fatal outcome. Definitive antemortem diagnosis of granulomatous angiitis requires a biopsy of involved tissue. The cause of granulomatous angiitis, as well as the nature of its association with Hodgkin's disease, remains unexplained.
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Affiliation(s)
- D J Inwards
- Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, MN 55905
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46
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Akrawy MZ, Alexander G, Allison J, Allport PP, Anderson KJ, Armitage JC, Arnison GTJ, Ashton P, Azuelos G, Baines JTM, Ball AH, Banks J, Barker GJ, Barlow RJ, Batley JR, Beck A, Becker J, Behnke T, Bell KW, Bella G, Bethke S, Biebel O, Binder U, Bloodworth IJ, Bock P, Breuker H, Brown RM, Brun R, Buijs A, Burckhart HJ, Capiluppi P, Carnegie RK, Carter AA, Carter JR, Chang CY, Charlton DG, Chrin JTM, Clarke PEL, Cohen I, Collins WJ, Conboy JE, Couch M, Coupland M, Cuffiani M, Dado S, Dallavalle GM, Debu P, Deninno MM, Dieckmann A, Dittmar M, Dixit MS, Duchovni E, Duerdoth IP, Dumas DJP, Elcombe PA, Estabrooks PG, Etzion E, Fabbri F, Farthouat P, Fischer HM, Fong DG, French MT, Fukunaga C, Gaidot A, Ganel O, Gary JW, Gascon J, Geddes NI, Gee CNP, Geich-Gimbel C, Gensler SW, Gentit FX, Giacomelli G, Gibson V, Gibson WR, Gillies JD, Goldberg J, Goodrick MJ, Gorn W, Granite D, Gross E, Grunhaus J, Hagedorn H, Hagemann J, Hansroul M, Hargrove CK, Harrus I, Hart J, Hattersley PM, Hauschild M, Hawkes CM, Heflin E, Hemingway RJ, Heuer RD, Hill JC, Hillier SJ, Ho C, Hobbs JD, Hobson PR, Hochman D, Holl B, Homer RJ, Hou SR, Howarth CP, Hughes-Jones RE, Humbert R, Igo-Kemenes P, Ihssen H, Imrie DC, Janissen L, Jawahery A, Jeffreys PW, Jeremie H, Jimack M, Jobes M, Jones RWL, Jovanovic P, Karlen D, Kawagoe K, Kawamoto T, Kellogg RG, Kennedy BW, Kleinwort C, Klem DE, Knop G, Kobayashi T, Kokott TP, K�pke L, Kowalewski R, Kreutzmann H, Kroll J, Kuwano M, Kyberd P, Lafferty GD, Lamarche F, Larson WJ, Layter JG, Du P, Leblanc P, Lee AM, Lehto MH, Lellouch D, Lennert P, Lessard L, Levinson L, Lloyd SL, Loebinger FK, Lorah JM, Lorazo B, Losty MJ, Ludwig J, Ma J, Macbeth AA, Mannelli M, Marcellini S, Maringer G, Martin AJ, Martin JP, Mashimo T, M�ttig P, Maur U, McMahon TJ, McNutt JR, Meijers F, Menszner D, Merritt FS, Mes H, Michelini A, Middleton RP, Mikenberg G, Mildenberger J, Miller DJ, Milstene C, Minowa M, Mohr W, Montanari A, Mori T, Moss MW, Murphy PG, Murray WJ, Nellen B, Nguyen HH, Nozaki M, O'Dowd AJP, O'Neale SW, O'Neill BP, Oakham FG, Odorici F, Ogg M, Oh H, Oreglia MJ, Orito S, Pansart JP, Patrick GN, Pawley SJ, Pfister P, Pilcher JE, Pinfold JL, Plane DE, Poli B, Pouladdej A, Prebys E, Pritchard TW, Quast G, Raab J, Redmond MW, Rees DL, Regimbald M, Riles K, Roach CM, Robins SA, Rollnik A, Roney JM, Rossberg S, Rossi AM, Routenburg P, Runge K, Runolfsson O, Sanghera S, Sansum RA, Sasaki M, Saunders BJ, Schaile AD, Schaile O, Schappert W, Scharff-Hansen P, Schreiber S, Schwarz J, Shapira A, Shen BC, Sherwood P, Simon A, Singh P, Siroli GP, Skuja A, Smith AM, Smith TJ, Snow GA, Springer RW, Sproston M, Stephens K, Stier HE, Stroehmer R, Strom D, Takeda H, Takeshita T, Taras P, Thackray NJ, Tsukamoto T, Turner MF, Tysarczyk-Niemeyer G, plas D, VanDalen GJ, Vasseur G, Virtue CJ, Schmitt H, Krogh J, Wagner A, Wahl C, Walker JP, Ward CP, Ward DR, Watkins PM, Watson AT, Watson NK, Weber M, Weisz S, Wells PS, Wermes N, Weymann M, Wilson GW, Wilson JA, Wingerter I, Winterer VH, Wood NC, Wotton S, Wuensch B, Wyatt TR, Yaari R, Yang Y, Yekutieli G, Yoshida T, Zeuner W, Zorn GT. A study of the recombination scheme dependence of jet production rates and of ? s ( $$M_{Z^0 } $$ ) in hadronicZ 0 decays. ACTA ACUST UNITED AC 1991. [DOI: 10.1007/bf01549689] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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47
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Alexander G, Allison J, Allport PP, Anderson KJ, Arcelli S, Armitage JC, Ashton P, Astbury A, Axen D, Azuelos G, Bahan GA, Baines JTM, Ball AH, Banks J, Barker GJ, Barlow RJ, Batley JR, Beaudoin G, Beck A, Becker J, Behnke T, Bell KW, Bella G, Bethke S, Biebel O, Binder U, Bloodworth IJ, Bock P, Bosch HM, Bougerolle S, Brabson BB, Breuker H, Brown RM, Brun R, Buijs A, Burckhart HJ, Capiluppi P, Carnegie RK, Carter AA, Carter JR, Chang CY, Charlton DG, Chrin JTM, Clarke PEL, Cohen I, Collins WJ, Conboy JE, Cooper M, Couch M, Coupland M, Cuffiani M, Dado S, Dallavalle GM, Jong S, Debu P, Deninno MM, Dieckmann A, Dittmar M, Dixit MS, Duchovni E, Duckeck G, Duerdoth IP, Dumas DJP, Eckerlin G, Elcombe PA, Estabrooks PG, Etzion E, Fabbri F, Fincke-Keeler M, Fischer HM, Fong DG, Fukunaga C, Gaidot A, Ganel O, Gary JW, Gascon J, McGowan RF, Geddes NI, Geich-Gimbel C, Gensler SW, Gentit FX, Giacomelli G, Gibson V, Gibson WR, Gillies JD, Goldberg J, Goodrick MJ, Gorn W, Grandi C, Gross E, Hagemann J, Hanson GG, Hansroul M, Hargrove CK, Harrison PF, Hart J, Hattersley PM, Hauschild M, Hawkes CM, Heflin E, Hemingway RJ, Heuer RD, Hill JC, Hillier SJ, Hinshaw DA, Ho C, Hobbs JD, Hobson PR, Hochman D, Holl B, Homer RJ, Hou SR, Howarth CP, Hughes-Jones RE, Humbert R, Igo-Kemenes P, Ihssen H, Imrie DC, Janissen L, Jawahery A, Jeffreys PW, Jeremie H, Jimack M, Jobes M, Jones RWL, Jovanovic P, Karlen D, Kawagoe K, Kawamoto T, Keeler RK, Kellogg RG, Kennedy BW, Kleinwort C, Klem DE, Kobayashi T, Kokott TP, Komamiya S, Köpke L, Kowalewski R, Kreutzmann H, Krogh J, Kroll J, Kuwano M, Kyberd P, Lafferty GD, Lamarche F, Larson WJ, Layter JG, Du P, Leblanc P, Lee AM, Lehto MH, Lellouch D, Lennert P, Leroy C, Lessard L, Levegrün S, Levinson L, Lloyd SL, Loebinger FK, Lorah JM, Lorazo B, Losty MJ, Lou XC, Ludwig J, Mannelli M, Marcellini S, Maringer G, Martin AJ, Martin JP, Mashimo T, Mättig P, Maur U, McMahon TJ, McNutt JR, Meijers F, Menszner D, Merritt FS, Mes H, Michelini A, Middleton RP, Mikenberg G, Mildenberger J, Miller DJ, Milstene C, Mir R, Mohr W, Moisan C, Montanari A, Mori T, Moss MW, Mouthuy T, Murphy PG, Nellen B, Nguyen HH, Nozaki M, O'Neale SW, O'Neill BP, Oakham FG, Odorici F, Ogg M, Ogren HO, Oh H, Oram CJ, Oreglia MJ, Orito S, Pansart JP, Panzer-Steindel B, Paschievici P, Patrick GN, Pawley SJ, Pfister P, Pilcher JE, Pinfold JL, Plane DE, Poffenberger P, Poli B, Pouladdej A, Prebys E, Pritchard TW, Przysiezniak H, Quast G, Redmond MW, Rees DL, Riles K, Robins SA, Robinson D, Rollnik A, Roney JM, Rossberg S, Rossi AM, Routenburg P, Runge K, Runolfsson O, Rust DR, Sanghera S, Sasaki M, Schaile AD, Schaile O, Schappert W, Scharff-Hansen P, Schenk P, Schmitt H, Schreiber S, Schwarz J, Scott WG, Settles M, Shen BC, Sherwood P, Shypit R, Simon A, Singh P, Siroli GP, Skuja A, Smith AM, Smith TJ, Snow GA, Sobie R, Springer RW, Sproston M, Stephens K, Stier HE, Strom D, Takeda H, Takeshita T, Taras P, Tarem S, Teixeira-Dias P, Thackray NJ, Tsukamoto T, Turner MF, Tysarczyk-Niemeyer G, plas D, Kooten R, Dalen GJ, Vasseur G, Virtue CJ, Wagner A, Wahl C, Walker JP, Ward CP, Ward DR, Watkins PM, Watson AT, Watson NK, Weber M, Weisz S, Wells PS, Wermes N, Weymann M, Whalley MA, Wilson GW, Wilson JA, Wingerter I, Winterer VH, Wood NC, Wotton S, Wyatt TR, Yaari R, Yangh Y, Yekutieli G, Zacharov I, Zeuner W, Zorn GT. Measurement of theZ 0 line shape parameters and the electroweak couplings of charged leptons. ACTA ACUST UNITED AC 1991. [DOI: 10.1007/bf01560437] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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48
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Abstract
We describe a case of inflammatory brachial plexopathy that occurred in the context of a mild, diffuse sensorimotor peripheral neuropathy associated with Hodgkin's disease. Clinical, electrophysiologic, and pathologic studies helped distinguish this disorder from other causes of brachial plexopathy in patients with cancer. Treatment with corticosteroids seemed beneficial in this patient. We suggest that this may be another type of paraneoplastic condition associated with Hodgkin's disease.
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Affiliation(s)
- D H Lachance
- Department of Neurology, Mayo Clinic, Rochester, MN 55905
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49
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Lachance DH, O'Neill BP, Macdonald DR, Jaeckle KA, Witzig TE, Li CY, Posner JB. Primary leptomeningeal lymphoma: report of 9 cases, diagnosis with immunocytochemical analysis, and review of the literature. Neurology 1991; 41:95-100. [PMID: 1985302 DOI: 10.1212/wnl.41.1.95] [Citation(s) in RCA: 118] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
We describe 9 patients who presented with a neoplastic meningitis of lymphomatous origin. No evidence of parenchymal central nervous system or systemic tumor was identified either at the time of presentation or throughout the course of their disease. We have chosen to call this entity "primary leptomeningeal lymphoma" (PLML). This unusual form of neurologic lymphoma must be differentiated from the more common clinical situations of primary parenchymal lymphoma with meningeal involvement and systemic lymphoma complicated by lymphomatous meningitis.
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Affiliation(s)
- D H Lachance
- Department of Neurology, Mayo Clinic, Rochester, MN 55905
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50
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Hetzel DJ, Stanhope CR, O'Neill BP, Lennon VA. Gynecologic cancer in patients with subacute cerebellar degeneration predicted by anti-Purkinje cell antibodies and limited in metastatic volume. Mayo Clin Proc 1990; 65:1558-63. [PMID: 2255217 DOI: 10.1016/s0025-6196(12)62189-2] [Citation(s) in RCA: 72] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Between 1982 and 1989, 19 patients with gynecologic carcinoma, paraneoplastic cerebellar degeneration, and seropositivity for anti-Purkinje cell cytoplasmic antibodies were identified at our institution. Seven of the patients had no clinical, computed tomographic, or magnetic resonance imaging evidence of cancer but had undergone laparotomy solely because anti-Purkinje cell antibodies were found in their serum; all had high-grade adenocarcinoma. Cerebellar symptoms preceded or coincided with the initial cancer diagnosis in 15 patients and preceded the diagnosis of recurrent cancer in 4 patients. The cancers were 14 ovarian, 2 fallopian tube, 2 surface papillary, and 1 poorly differentiated metastatic adenocarcinoma in a periaortic lymph node. Two remarkable surgical observations in patients with high-grade ovarian and tubal cancers were the conspicuous lack of peritoneal implants and the small metastatic volume. A comparison of the 8 patients who had primary stage III cancer with 24 matched control patients without paraneoplastic cerebellar degeneration revealed no difference in primary tumor volume but a significantly smaller volume of metastatic tumor in the seropositive group (P = 0.05). Anti-Purkinje cell antibodies were not detected in 111 neurologically normal patients with advanced ovarian cancer. The small metastatic volume in the face of high-grade and advanced stage malignancy in seropositive patients with paraneoplastic cerebellar degeneration suggests that an immune response to the tumor (presumably cross-reactive with cerebellar cells) may impair the metastatic process. Earlier diagnosis and treatment of cancer, based on prompt serologic testing, may offer an improved neurologic and oncologic prognosis.
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Affiliation(s)
- D J Hetzel
- Section of Gynecologic Surgery, Mayo Clinic, Rochester, MN 55905
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