Journal of Clinical Oncology, Vol 1, 677-681, Copyright © 1983 by American Society of Clinical Oncology
Central nervous system involvement in American Burkitt's lymphoma
E Sariban, B Edwards, C Janus and I Magrath
Sixty-four patients with American Burkitt's lymphoma (AMBL) treated at the
National Cancer Institute were reviewed to determine the frequency and
characteristics of central nervous system (CNS) involvement. Patients with
minimal or completely resected tumor never had CNS disease. Of the 45
patients with more extensive disease, 15 had CNS disease: nine presented
with CNS disease, six of whom subsequently had recurrent CNS disease, and
six developed CNS disease only at relapse. There was a significant
association between CNS and bone-marrow disease at presentation. Therapy of
CNS disease consisted of short courses of intrathecal chemotherapy with
cytosine arabinoside and methotrexate. Cranial irradiation was given only
to patients with CNS relapse. There are six long-term survivors (LTS) who
have been disease free for four to six years post chemotherapy. Of these
six LTS, three presented with CNS disease, two experienced isolated CNS
relapse, and one had CNS disease both at presentation and at relapse. Three
of the six LTS never received cranial irradiation. It is concluded that CNS
involvement in AMBL can be effectively treated, and that long-term
remission, which is probably cure, can be achieved.
