Characteristics at ibrutinib initiation and treatment outcomes of MCL patients with CNS relapse
| . | Patient 1 . | Patient 2 . | Patient 3 . |
|---|---|---|---|
| Age (y)/sex | 61/M | 62/M | 77/F |
| Performance status | 1 | 1 | 4 |
| Ann Arbor Stage | IV | IV | IV |
| LDH | high | normal | normal |
| MIPI score | 5.5 (low risk) | 5.8 (intermediate risk) | 7.7 (high risk) |
| Ki67 | 60% | 20% | 70% |
| Blastoid histology | No | No | No |
| Prior lines of therapy | 3 | 2 | 2 |
| Prior HDT + ASCT | Yes | Yes | No |
| Clinical disease symptoms | Proptosis | Complete motor deficit (lower limbs) | Bilateral motor deficit |
| Ipsilateral optic nerve infiltration | Impaired bladder bowel control | Severe pain (lower limbs) | |
| Complete right blindness | |||
| Intracerebral lesion | Right retro-orbital mass (30 × 32 mm) with intradural infiltration | Asymptomatic left temporal cerebral mass (15 × 18 mm) | Asymptomatic left extradural retro-orbital mass (12 × 14mm) |
| Intraspinal lesion | No | Transverse myelitis (MRI): 90 mm with contrast enhancement | No |
| CSF involvement | Not assessed | No | Yes |
| Extra-CNS involvement | Left subclavian nodes | No | No |
| Left axillary mass (74 × 55 mm) | |||
| Subcutaneous nodes | |||
| Response | CR | CR | PR |
| Time to clinical response | 1 wk | 3 d | 1 wk |
| Follow-up | 1 y | 9 mo | 2 mo |
| Status at last follow-up | CR | CR | PR |
| Toxicity | No | No | No |
| . | Patient 1 . | Patient 2 . | Patient 3 . |
|---|---|---|---|
| Age (y)/sex | 61/M | 62/M | 77/F |
| Performance status | 1 | 1 | 4 |
| Ann Arbor Stage | IV | IV | IV |
| LDH | high | normal | normal |
| MIPI score | 5.5 (low risk) | 5.8 (intermediate risk) | 7.7 (high risk) |
| Ki67 | 60% | 20% | 70% |
| Blastoid histology | No | No | No |
| Prior lines of therapy | 3 | 2 | 2 |
| Prior HDT + ASCT | Yes | Yes | No |
| Clinical disease symptoms | Proptosis | Complete motor deficit (lower limbs) | Bilateral motor deficit |
| Ipsilateral optic nerve infiltration | Impaired bladder bowel control | Severe pain (lower limbs) | |
| Complete right blindness | |||
| Intracerebral lesion | Right retro-orbital mass (30 × 32 mm) with intradural infiltration | Asymptomatic left temporal cerebral mass (15 × 18 mm) | Asymptomatic left extradural retro-orbital mass (12 × 14mm) |
| Intraspinal lesion | No | Transverse myelitis (MRI): 90 mm with contrast enhancement | No |
| CSF involvement | Not assessed | No | Yes |
| Extra-CNS involvement | Left subclavian nodes | No | No |
| Left axillary mass (74 × 55 mm) | |||
| Subcutaneous nodes | |||
| Response | CR | CR | PR |
| Time to clinical response | 1 wk | 3 d | 1 wk |
| Follow-up | 1 y | 9 mo | 2 mo |
| Status at last follow-up | CR | CR | PR |
| Toxicity | No | No | No |
ASCT, autologous stem cell transplantation; CNS, central nervous system; CR, complete response; CSF, cerebrospinal fluid; HDT, high-dose therapy; LDH, lactate dehydrogenase; PR, partial response.