Overt central nervous system (CNS) involvement in aggressive non-Hodgkin's lymphoma (NHL) is rare at diagnosis. Much effort is put to identify risk factors for occult CNS involvement, and the risk assessment of CNS relapse. Prophylactic treatment carries risk of adverse events and its efficacy is not clear. Detection of cerebrospinal fluid molecular gene rearrangement (GRR) as a method to detect occult disease has been studied in acute leukemia and primary CNS lymphoma. To date, the capacity of a positive GRR in newly diagnosed NHL patients to predict CNS relapse has not been addressed. We retrospectively studied the prognostic value of GRR in cerebrospinal fluid samples of 148 newly diagnosed patients with high grade NHL. We demonstrate that positive GRR at diagnosis does not affect PFS or OS and did not predict CNS relapse. However, although numbers were small, repeated positive samples (≥ 2) correlated with a higher risk for CNS relapse (p = 0.048), possibly stressing the need for an aggressive preventive approach.

中文翻译：

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新诊断的非霍奇金淋巴瘤患者的脑脊髓克隆基因重排评估。

在诊断中很少出现明显的中枢神经系统（CNS）参与侵袭性非霍奇金淋巴瘤（NHL）。人们付出了很多努力来确定隐匿性中枢神经系统受累的危险因素，以及中枢神经系统复发的风险评估。预防性治疗具有发生不良事件的风险，其疗效尚不清楚。在急性白血病和原发性中枢神经系统淋巴瘤中，研究了脑脊液分子基因重排（GRR）检测作为隐匿性疾病的一种方法。迄今为止，尚未解决在新诊断的NHL患者中GRR阳性的预测CNS复发的能力。我们回顾性研究了GRR在148例新诊断的高级别NHL患者的脑脊液样本中的预后价值。我们证明，诊断时阳性的GRR不会影响PFS或OS，也不能预测CNS复发。然而，