High incidence of occult leptomeningeal disease detected by flow cytometry in newly diagnosed aggressive B-cell lymphomas at risk for central nervous system involvement: The role of flow cytometry versus cytology

Upendra Hegde, Armando Filie, Richard F. Little, John E. Janik, Nicole Grant, Seth M. Steinberg, Kieron Dunleavy, Elaine S. Jaffe, Andrea Abati, Maryalice Stetler-Stevenson, Wyndham H. Wilson

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264 Scopus citations

Abstract

We assessed the cerebrospinal fluid (CSF) by flow cytometry and cytology in 51 newly diagnosed and 9 treated aggressive B-cell lymphomas at risk for central nervous system (CNS) involvement to examine the utility of flow cytometry, incidence of CSF disease, and clinical surrogates of CNS spread. Multicolor flow cytometry using multiple antibody panels for light chains and B- and T-cell antigens identified neoplastic clones that constituted as little as 0.2% of total CSF lymphocytes. Among 51 newly diagnosed patients, 11 (22%) had occult CSF involvement. All 11 were detected by flow cytometry but only 1 by cytology (P = .002). Among 9 treated patients, CSF involvement was detected by flow cytometry alone in 2 and also by cytology in 1 case. CSF chemistry and cell counts were similar in patients with and without CSF lymphoma. Only the number of extranodal sites was associated with occult CSF lymphoma in newly diagnosed patients by univariate (P = .006) or logistic regression analysis (P = .012). We hypothesize that the biologic phenotype associated with colonization of extranodal sites leads to CNS spread, possibly related to the microenvironment. Patients at risk for CNS spread should undergo staging CSF evaluation by flow cytometry.

Original languageEnglish (US)
Pages (from-to)496-502
Number of pages7
JournalBlood
Volume105
Issue number2
DOIs
StatePublished - Jan 15 2005

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ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

Cite this

Hegde, U., Filie, A., Little, R. F., Janik, J. E., Grant, N., Steinberg, S. M., Dunleavy, K., Jaffe, E. S., Abati, A., Stetler-Stevenson, M., & Wilson, W. H. (2005). High incidence of occult leptomeningeal disease detected by flow cytometry in newly diagnosed aggressive B-cell lymphomas at risk for central nervous system involvement: The role of flow cytometry versus cytology. Blood, 105(2), 496-502. https://doi.org/10.1182/blood-2004-05-1982