To describe the demographic and tumor related characteristics and outcomes for patients with primary T-cell CNS lymphoma (TPCNSL).
A retrospective series of patients with TPCNSL was compiled from ...twelve cancer centers in seven countries.
We identified 45 patients with a median age of 60 years (range, 3 to 84 years). Twenty (44%) had Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 or 1. Twenty-six (58%) had involvement of a cerebral hemisphere and sixteen (36%) had lesions of deeper sites in the brain. Serum lactate dehydrogenase was elevated in 7 (32%) of 22 patients, and CSF protein was elevated in 19 of 24 patients (79%) with available data. The median disease-specific survival (DSS) was 25 months (95% CI, 11 to 38 months). The 2- and 5-year DSS were 51% (95% CI, 35% to 66%) and 17% (95% CI, 6% to 34%), respectively. Univariate and multivariate analyses were conducted for age (</= 60 v > 60 years), PS (0 or 1 v 2, 3, or 4), involvement of deep structures of the CNS (no v yes), and methotrexate (MTX) use in the primary treatment (yes v no). Only PS and MTX use were significantly associated with better outcome with hazard ratios of 0.2 (95% CI, 0.1 to 0.4) and 0.4 (95% CI, 0.2 to 0.8), respectively.
This is the largest series ever assembled of TPCNSL. The presentation and outcome appear similar to that of B cell PCNSL. PS 0 or 1 and administration of MTX are associated with better survival.
Brain metastases Klos, Kevin J; O'Neill, Brian Patrick
The Neurologist (Baltimore, Md.)
10, Issue:
1
Journal Article
Peer reviewed
Systemic cancer is the second most common cause of death for adults in the United States. Twenty percent of these patients develop neurologic symptoms sometime during their illness. An apparent ...increase in the incidence of both systemic cancers and resulting brain metastases are posing an increasing challenge to health care providers. Neurologic complications lead to significant morbidity and mortality in these patients. Therefore, it is important to understand the current concepts of diagnosis and treatment of patients with brain metastases.
This review summarizes the epidemiology, clinical features, pathophysiology, and diagnostic evaluation of brain metastases. The section on current treatments is presented from the perspective of the three most common primary tumor locations along with the treatment approach to other metastatic tumors. This review includes a thorough evaluation of the literature, highlights controversies over treatment options, and provides insight into novel approaches currently under investigation. Clinical studies needed for further study are also discussed.
A clearer understanding of the pathophysiology of metastatic tumors and advances in diagnostic technology have paved the road to a better approach to treatment of brain metastases. Although no curative treatments are available to date, significant improvement in a patient's quality of life and life expectancy can be achieved with the available therapy. A better understanding of different primary cancers leading to brain metastases leads to a more effective treatment. More studies are needed to critically analyze the clear benefit of these treatment options in selected patients.
Abstract
Purpose: To compare the cytokine spectrum of vitreoretinal lymphoma to uveitis and correlate cytokine concentrations with disease activity.
Methods: Retrospective case series of 10 patients ...with vitreoretinal lymphoma and 7 patients with uveitis. Aqueous humor concentration of IFN-γ, TNF-α, TNF-β, IL-1ra, IL-1β, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12, IL-13, IL-17, MCP-1, G-CSF, GM-CSF, and VEGF-A was determined using a bead-based assay (Luminex). Variance between groups, correlation coefficients, and longitudinal behavior of cytokines were analyzed.
Results: No statistically significant difference in cytokines was found when comparing groups. IL-10 was positively correlated with IL-6 and MCP-1. IL-6 was positively correlated with G-CSF, IL-1ra, IL-8, and IL-10. A relationship between concentration of any cytokine, aside from IL-10, and disease activity was not found.
Conclusion: IL-10 and IL-6 are good immunologic markers to be used as complementary diagnostic tools. IL-10 is the only IL that could be used for monitoring purposes.
Web Characterization Project O'neill, Edward T.; Lavoie, Brian F.; McClain, Patrick D.
Journal of library administration,
2001, Volume:
34, Issue:
3-4
Journal Article
Peer reviewed
Discovery and description of Web resources are currently facilitated by the use of metadata. Although much work has been conducted in developing metadata architectures and standards, few studies have ...undertaken to assess current metadata usage in Web documents. An analysis of this kind is challenging in view of the difficulty of data collection. A practical approach is to collect a representative sample of Web documents, from which valid inferences can be made concerning the Web as a whole. The Web Characterization Project has developed a methodology for extracting a valid sample from the Web. Using data from a sample collected in June 1998, this paper characterizes the use of metadata in Web documents.