A new prognostic score for disease progression and mortality in patients with newly diagnosed primary CNS lymphoma

Abstract

Background Although various prognostic models for primary central nervous system lymphoma (PCNSL) have been developed, there is no consensus regarding the optimal prognostic index. We aimed to evaluate potential prognostic factors and construct a novel predictive model for PCNSL patients. Methods We enrolled newly diagnosed PCNSL patients between 2003 and 2015. The primary endpoint was progression‐free survival (PFS), and the secondary endpoint was overall survival (OS). The prognostic factors identified using multivariate Cox proportional hazards models were used to develop a predictive model. We subsequently validated the prognostic model in an independent cohort. We also evaluated the validity of the existing scores: the International Extranodal Lymphoma Study Group (IELSG), the Nottingham/Barcelona (NB), and the Memorial Sloan‐Kettering Cancer Center models (MSKCC). Results We identified 101 patients with newly diagnosed PCNSL at our center. Multivariate analysis showed that age ≥80, deep brain lesions, and ECOG ≥2 were independent risk factors of PFS. Assigning one point for each factor, we constructed a novel prognostic model, the Taipei Score, with four distinct risk groups (0‐3 points). The performances of the Taipei Score in discriminating both PFS and OS in the training cohort were significant, and the score was validated in the external validation cohort. The IELSG, NB and MSKCC models had insufficient discriminative ability for either PFS or OS in both cohorts. Conclusion The Taipei Score is a simple model that discriminates PFS and OS for PCNSL patients. The score may offer disease risk stratification and facilitate clinical decision‐making.

Prognostic Role of Blood Markers in Primary Central Nervous System Lymphoma Patients Treated With High-Dose Methotrexate-Based Therapy

“…In the MSKCC score, Karnofsky performance status (KPS) ≥ 70 and age ≥ 50 years were used as two prognostic factors dividing patients into three risk groups ( 11 ). This score is simpler while still controversial in several recent studies ( 9 , 12 , 13 ). Furthermore, these prognostic models need to be confirmed in the modern combination chemotherapy regimens based on HD-MTX and should be optimized to better distinguish risk groups.…”

A Novel Prognostic Marker for Primary CNS Lymphoma: Lactate Dehydrogenase-to-Lymphocyte Ratio Improves Stratification of Patients Within the Low and Intermediate MSKCC Risk Groups

“…The IELSG and NB models showed poor separation for both PFS and OS, while the MSKCC score demonstrated a significant discrimination in terms of PFS in the training cohort. Based on these data, the IELSG, NB, and MSKCC scores showed an insufficient prognostic capability, although the MSKCC score performed better than the IELSG and NB models ( 33 ). These limitations of the proposed prognostic scoring systems highlight the importance of real-life feasibility when proposing novel prognostic models.…”

Primary Pituitary Lymphoma in Immunocompetent Patients: A Report on Two Case Studies and the Review of Literature

“…A newly developed prognostic score for PCNSL (Taipei Score) may offer disease risk stratification and facilitate clinical decision-making. Here, an age ≥80, deep brain lesions, and ECOG ≥2 were considered independent risk factors for PFS where each factor was assigned one point and there were four distinct risk groups (0–3 points) ( 60 ). Currently, the prediction of prognosis and treatment modalities of PPL follow the protocols of PCNSL due to its extreme rarity and also the scarcity of adequate research materials.…”