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                  <mods:namePart>Wilson, Wyndham H.</mods:namePart>
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                  <mods:namePart>Filie, Armando</mods:namePart>
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                  <mods:namePart>Dunleavy, Kieron</mods:namePart>
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                  <mods:namePart>Mehrling, Thomas</mods:namePart>
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                  <mods:namePart>Spina, Michele</mods:namePart>
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                  <mods:namePart>Orfao, Alberto</mods:namePart>
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                  <mods:dateIssued encoding="iso8601">2018-11-08T14:26:48Z2018-11-08T14:26:48Z2014-072018-11-08T14:26:48Z</mods:dateIssued>
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               <mods:abstract>The benefit of intrathecal therapy and systemic rituximab on the outcome of diffuse large B-cell lymphoma at risk of central nervous system disease is controversial. Furthermore, the effect of intrathecal treatment and rituximab in diffuse large B-cell and Burkitt lymphoma with occult leptomeningeal disease detected by flow cytometry at diagnosis is unknown. Untreated diffuse large B-cell (n=246) and Burkitt (n=80) lymphoma at clinical risk of central nervous system disease and having had pre-treatment cerebrospinal fluid were analyzed by flow cytometry and cytology. Spinal fluid involvement was detected by flow cytometry alone (occult) in 33 (13%) diffuse large B-cell and 9 (11%) Burkitt lymphoma patients, and detected by cytology in 11 (4.5%) and 5 (6%) patients, respectively. Diffuse large B-cell lymphoma with occult spinal fluid involvement had poorer survival (P=0.0001) and freedom from central nervous system relapse (P&lt;0.0001) compared to negative cases. Burkitt lymphoma with occult spinal fluid involvement had an inferior freedom from central nervous system relapse (P=0.026) but not survival. The amount of intrathecal chemotherapy was quantitatively associated with survival in diffuse large B-cell lymphoma with (P=0.02) and without (P=0.001) occult spinal fluid involvement. However, progression of systemic disease and not control of central nervous system disease was the principal cause of treatment failure. In diffuse large B-cell lymphoma, systemic rituximab was associated with improved freedom from central nervous system relapse (P=0.003) but not with survival. Our results suggest that patients at risk of central nervous system disease should be evaluated by flow cytometry and that intrathecal prophylaxis/therapy is beneficial.</mods:abstract>
               <mods:language>
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               <mods:accessCondition type="useAndReproduction">(c) Ferrata Storti Foundation, 2014 info:eu-repo/semantics/openAccess</mods:accessCondition>
               <mods:subject>
                  <mods:topic>Limfomes</mods:topic>
               </mods:subject>
               <mods:subject>
                  <mods:topic>Citometria de fluxe</mods:topic>
               </mods:subject>
               <mods:subject>
                  <mods:topic>Lymphomas</mods:topic>
               </mods:subject>
               <mods:subject>
                  <mods:topic>Flow cytometry</mods:topic>
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               <mods:titleInfo>
                  <mods:title>Detection and outcome of occult leptomeningeal disease in diffuse large B-cell lymphoma and Burkitt lymphoma</mods:title>
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