{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:32:25Z","timestamp":1760189545234},"reference-count":21,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"16","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2000,8,16]]},"abstract":"<jats:p> PURPOSE: To determine the frequency of CNS involvement at diagnosis of non-Hodgkin\u2019s lymphoma (NHL), to characterize its pattern of presentation, and to determine its prognostic significance. <\/jats:p><jats:p> PATIENTS AND METHODS: We reviewed the records of 445 children (1975 through 1995) diagnosed with NHL (small noncleaved cell NHL\/B-cell acute lymphoblastic leukemia [SNCC NHL\/B-ALL], 201 patients; lymphoblastic, 113; large cell, 119; other, 12). Tumor burden was estimated by serum lactate dehydrogenase (LDH) measurement and reclassification of disease stage irrespective of CNS involvement (modified stage). <\/jats:p><jats:p> RESULTS: Thirty-six of 445 children with newly diagnosed NHL had CNS involvement (lymphoma cells in the CSF [n = 23], cranial nerve palsy [n = 9], both features [n = 4]), representing 13%, 7%, and 1% of small noncleaved cell lymphoma, lymphoblastic lymphoma, and large-cell cases, respectively. By univariate analysis, CNS disease at diagnosis did not significantly impact event-free survival (P = .095), whereas stage and LDH did; however, children with CNS disease at diagnosis were at 2.0 times greater risk of death than those without CNS disease at diagnosis. In a multivariate analysis, CNS disease was not significantly associated with either overall or event-free survival, whereas both serum LDH and stage influenced both overall and event-free survival. Among cases of SNCC NHL\/B-ALL, CNS disease was significantly associated with event-free and overall survival (univariate analysis); however, in multivariate analysis, only LDH had independent prognostic significance. Elevated serum LDH or higher modified stage were associated with a trend toward poorer overall survival among children with CNS disease. <\/jats:p><jats:p> CONCLUSION: A greater tumor burden at diagnosis adversely influences the treatment outcome of children with NHL and CNS disease at diagnosis, suggesting a need for ongoing improvement in both systemic and CNS-directed therapy. <\/jats:p>","DOI":"10.1200\/jco.2000.18.16.3018","type":"journal-article","created":{"date-parts":[[2017,2,24]],"date-time":"2017-02-24T09:19:48Z","timestamp":1487927988000},"page":"3018-3024","source":"Crossref","is-referenced-by-count":31,"title":["CNS Involvement in Children With Newly Diagnosed Non-Hodgkin\u2019s Lymphoma"],"prefix":"10.1200","volume":"18","author":[{"given":"John T.","family":"Sandlund","sequence":"first","affiliation":[{"name":"From the Departments of Hematology\/OncologyRadiation Therapy, Pathology and Laboratory Medicine, and Biostatistics, St Jude Children\u2019s Research Hospital, and University of Tennessee at Memphis, College of Medicine, Memphis, TN; and Department of Pediatrics, Northwestern University School of Medicine, and Children\u2019s Memorial Hospital, Chicago, IL."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon B.","family":"Murphy","sequence":"additional","affiliation":[{"name":"From the Departments of Hematology\/OncologyRadiation Therapy, Pathology and Laboratory Medicine, and Biostatistics, St Jude Children\u2019s Research Hospital, and University of Tennessee at Memphis, College of Medicine, Memphis, TN; and Department of Pediatrics, Northwestern University School of Medicine, and Children\u2019s Memorial Hospital, Chicago, IL."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor M.","family":"Santana","sequence":"additional","affiliation":[{"name":"From the Departments of Hematology\/OncologyRadiation Therapy, Pathology and Laboratory Medicine, and Biostatistics, St Jude Children\u2019s Research Hospital, and University of Tennessee at Memphis, College of Medicine, Memphis, TN; and Department of Pediatrics, Northwestern University School of Medicine, and Children\u2019s Memorial Hospital, Chicago, IL."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederick","family":"Behm","sequence":"additional","affiliation":[{"name":"From the Departments of Hematology\/OncologyRadiation Therapy, Pathology and Laboratory Medicine, and Biostatistics, St Jude Children\u2019s Research Hospital, and University of Tennessee at Memphis, College of Medicine, Memphis, TN; and Department of Pediatrics, Northwestern University School of Medicine, and Children\u2019s Memorial Hospital, Chicago, IL."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dana","family":"Jones","sequence":"additional","affiliation":[{"name":"From the Departments of Hematology\/OncologyRadiation Therapy, Pathology and Laboratory Medicine, and Biostatistics, St Jude Children\u2019s Research Hospital, and University of Tennessee at Memphis, College of Medicine, Memphis, TN; and Department of Pediatrics, Northwestern University School of Medicine, and Children\u2019s Memorial Hospital, Chicago, IL."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Costan W.","family":"Berard","sequence":"additional","affiliation":[{"name":"From the Departments of Hematology\/OncologyRadiation Therapy, Pathology and Laboratory Medicine, and Biostatistics, St Jude Children\u2019s Research Hospital, and University of Tennessee at Memphis, College of Medicine, Memphis, TN; and Department of Pediatrics, Northwestern University School of Medicine, and Children\u2019s Memorial Hospital, Chicago, IL."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wayne L.","family":"Furman","sequence":"additional","affiliation":[{"name":"From the Departments of Hematology\/OncologyRadiation Therapy, Pathology and Laboratory Medicine, and Biostatistics, St Jude Children\u2019s Research Hospital, and University of Tennessee at Memphis, College of Medicine, Memphis, TN; and Department of Pediatrics, Northwestern University School of Medicine, and Children\u2019s Memorial Hospital, Chicago, IL."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raul","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"From the Departments of Hematology\/OncologyRadiation Therapy, Pathology and Laboratory Medicine, and Biostatistics, St Jude Children\u2019s Research Hospital, and University of Tennessee at Memphis, College of Medicine, Memphis, TN; and Department of Pediatrics, Northwestern University School of Medicine, and Children\u2019s Memorial Hospital, Chicago, IL."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William M.","family":"Crist","sequence":"additional","affiliation":[{"name":"From the Departments of Hematology\/OncologyRadiation Therapy, Pathology and Laboratory Medicine, and Biostatistics, St Jude Children\u2019s Research Hospital, and University of Tennessee at Memphis, College of Medicine, Memphis, TN; and Department of Pediatrics, Northwestern University School of Medicine, and Children\u2019s Memorial Hospital, Chicago, IL."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carol","family":"Greenwald","sequence":"additional","affiliation":[{"name":"From the Departments of Hematology\/OncologyRadiation Therapy, Pathology and Laboratory Medicine, and Biostatistics, St Jude Children\u2019s Research Hospital, and University of Tennessee at Memphis, College of Medicine, Memphis, TN; and Department of Pediatrics, Northwestern University School of Medicine, and Children\u2019s Memorial Hospital, Chicago, IL."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gang","family":"Chen","sequence":"additional","affiliation":[{"name":"From the Departments of Hematology\/OncologyRadiation Therapy, Pathology and Laboratory Medicine, and Biostatistics, St Jude Children\u2019s Research Hospital, and University of Tennessee at Memphis, College of Medicine, Memphis, TN; and Department of Pediatrics, Northwestern University School of Medicine, and Children\u2019s Memorial Hospital, Chicago, IL."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Walter","sequence":"additional","affiliation":[{"name":"From the Departments of Hematology\/OncologyRadiation Therapy, Pathology and Laboratory Medicine, and Biostatistics, St Jude Children\u2019s Research Hospital, and University of Tennessee at Memphis, College of Medicine, Memphis, TN; and Department of Pediatrics, Northwestern University School of Medicine, and Children\u2019s Memorial Hospital, Chicago, IL."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ching-Hon","family":"Pui","sequence":"additional","affiliation":[{"name":"From the Departments of Hematology\/OncologyRadiation Therapy, Pathology and Laboratory Medicine, and Biostatistics, St Jude Children\u2019s Research Hospital, and University of Tennessee at Memphis, College of Medicine, Memphis, TN; and Department of Pediatrics, Northwestern University School of Medicine, and Children\u2019s Memorial Hospital, Chicago, IL."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"233","reference":[{"key":"R2-0404","unstructured":"Murphy  SB:  Classification, staging and end results of treatment of childhood non-Hodgkin\u2019s lymphoma:  Dissimilarities from lymphoma in adults. 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