Publication Date:
2015-12-03
Description:
Identifying the etiology of neurological symptoms in hematological malignancies is still a challenging issue. Lymphomatous meningitis (LM) is mainly described in aggressive systemic B-cell lymphomas (diffuse large B-cell (DLBCL) and Burkitt lymphomas), and is associated with poor prognosis. Leptomeningeal involvement in small B-cell lymphoproliferation is a rare, poorly described condition, mentioned only in case reports. The diagnosis relies on the combination of non-specific central nervous system (CNS) symptoms (headaches, paraplegia, etc.) or psychiatric symptoms, and the cytological detection of tumor cells in the cerebrospinal fluid (CSF). However, cell analysis has a low sensitivity here due to the small drawn volumes of CSF samples, their poor cellularity and cell viability. Soluble biomarkers can be measured by multiplex techniques on small sample volumes, hence can overcome cytological limitations and seem fairly interesting for further investigations. The aim of the present study was to evaluate the diagnostic value of interleukin (IL)-10 and IL-6 quantification combined with the IL-10:IL-6 ratio in CSF of patients suffering from LM secondary to systemic small B-cell lymphoproliferations. Seventeen patients suffering from LM were included in the study: 4 with chronic lymphocytic leukemia (CLL), 2 with mantle-cell lymphoma (MCL) and 11 with Waldenström's macroglobulinemia (WM). All patients presented CNS symptoms associated with documented LM (revealed either by conventional cytology and/or flow cytometry) at the diagnostic stage and before intrathecal chemotherapy. IL-10 and IL-6 quantifications were performed in CSF using the quantitative Cytometric Bead Array® technique (human IL-10 CBA kit and human IL-6 CBA kit; BD BiosciencesTM) on a FACSCanto II flow cytometer (BD BiosciencesTM) following the manufacturer's recommendations, with a limit of detection of 2.5 pg/ml. All CLL and MCL patients displayed an undetectable level of IL-10 (
Print ISSN:
0006-4971
Electronic ISSN:
1528-0020
Topics:
Biology
,
Medicine