New Prognostic Model Predicts CNS Relapse in Patients With T-Cell Lymphomas

Stefan K. Barta, MD, MS, of the University of Pennsylvania, discusses his recent study on central nervous system (CNS) relapse in T-cell lymphomas.

“The [CNS] is usually a sanctuary site,” Dr. Barta began. “Most chemotherapy or other therapies we are giving patients to treat their lymphoma do not go there or penetrate the CNS. Therefore, cancer cells can be hiding out there.”

Dr. Barta and colleagues collected data from patients who experienced CNS relapse from 19 North American institutions and looked for unifying characteristics.

“We found that having two extranodal sites of involvement at diagnosis was associated with a high risk of CNS relapse later,” he explained. Other risk factors include increased lactate dehydrogenase, the presence of B symptoms, and certain subtypes of T-cell lymphoma such as peripheral T-cell lymphoma, NOS (not otherwise specified), and intestinal T-cell lymphoma.

The researchers then developed the CNS relapse in T-cell lymphoma Index (CITI), a prognostic model that helps predict the risk of CNS relapse at diagnosis.

“We have learned that if patients have low-risk disease, the risk of CNS relapse is only about 2%, whereas if they have high-risk disease, it’s around 13%,” Dr. Barta concluded. “Unfortunately, what we do not know is how to prevent CNS relapse, and that’s certainly a big area of need.”