Epidemiology of Brain Lymphoma Among People With or Without Acquired Immunodeficiency Syndrome

Coté, Timothy R.; Manns, Angela; Hardy, Catherine; Yellin, Frances; Hartge, Patricia

doi:10.1093/jnci/88.10.675

Cited by 218 publications

(117 citation statements)

References 7 publications

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“…However, when compared with literature in the context of primary CNS lymphomas, our patient demographics are consistent with existing reports. 21,22 The histological type of PISCL in this study consisted mainly of B-cell origin lymphoma, and the most prevalent overall lymphoma is diffuse large B-cell lymphoma, …”

Section: Discussionmentioning

confidence: 89%

Primary intramedullary spinal cord lymphoma: a population-based study

Yang

Garzón-Muvdi

Braileanu

et al. 2016

NEUONC

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Background. Primary intramedullary spinal cord lymphoma (PISCL) is a rare diagnosis with poorly understood disease progression. Clarification of the factors associated with survival in PISCL patients is warranted. Methods. We conducted a population-based cohort study utilizing prospectively collected data from the Surveillance, Epidemiology, and End Results (SEER) database. Patients with histological diagnosis of primary lymphoma in spinal cord (C72.0) from 1973 to 2012 in the SEER database were included. Multivariable survival analysis between patient, lesion characteristics, and PISCL-related death was performed to adjust for confounding factors. Results. We included 346 PISCL patients in our study. Average age was 56.5 ± 17.8 years, with 62.7% being male. Racial distribution of these patients was white (87.6%), black (8.0%), and other (4.3%). More than half (55.8%) of patients were married. The most prevalent histology of PISCL was diffuse B-cell (46.2%), and the majority (55.2%) were low stage (Ann Arbor stage I/II). Most patients (67.9%) received radiation therapy. Average survival interval of patients with PISCL-related death (n=135, 39.0%) was 27.8 months. General cumulative survival probability at 1 year, 2 years, and 5 years was 73.8%, 67.9%, and 63.1%, respectively. Multivariable accelerated failure time (AFT) regression showed follicular lymphoma (HR:0.25, P=.008) and more recent diagnosis (HR:0.96, P<.001) was positively associated with PISCL-related survival. Conversely, nonwhite race (HR:1.69, P=.046), older age (HR:1.02, P<.001), unmarried status (HR:2.14, P<.001), and higher stage (HR:1.54, P=.022) were negatively associated with survival. Conclusions. Age, race, marital status, tumor histology, tumor stage, and year of diagnosis were associated with survival of PISCL. While most PISCL-related deaths occur within a 1-year period, subsequent slow progression was observed after the first year of survival.

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Section: Discussionmentioning

confidence: 89%

Primary intramedullary spinal cord lymphoma: a population-based study

Yang

Garzón-Muvdi

Braileanu

et al. 2016

NEUONC

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“…1 This figure has been increasing dramatically since the 1970s, in part due to the AIDS epidemic, but also due to an unexplained increased occurrence of the tumor in immunocompetent persons. 2 Patients with PCNSL may experience a variety of rapidly progressive neurologic deficits, and, if untreated, generally die within 3 months as a result of progressive intracranial disease. 3 Prognosis may be improved with aggressive chemotherapy and radiotherapy regimens, but most clinical series report a 5-year survival rate below 10%.…”

Section: Introductionmentioning

confidence: 99%

Expression of B-cell–attracting chemokine 1 (CXCL13) by malignant lymphocytes and vascular endothelium in primary central nervous system lymphoma

Smith

Braziel

Paoletti

et al. 2003

Blood

178

118

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“…1 However, even in immunocompetent individuals, the incidence of primary central nervous system lymphoma is increasing. [3][4][5] The most common type of primary central nervous system lymphoma is the diffuse large B-cell type. 6 Primary central nervous system diffuse large B-cell lymphoma carries a poor prognosis despite multimodal treatment with methotrexate-based chemotherapy and radiotherapy.…”

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confidence: 99%

Most primary central nervous system diffuse large B-cell lymphomas occurring in immunocompetent individuals belong to the nongerminal center subtype: a retrospective analysis of 31 cases

et al. 2010

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Primary central nervous system lymphomas are rare neoplasms characterized by a dismal prognosis relative to other extranodal lymphomas. Approximately 98% of primary central nervous system lymphomas are of B-cell origin, and most belong to the diffuse large B-cell type. Recently, diffuse large B-cell lymphomas have been subcategorized into germinal center and nongerminal center types based on gene expression profiles and immunohistochemical expression of CD10, Bcl-6, and MUM1. Studies have shown that the overall survival rate of the germinal center group is better than that of the nongerminal center lymphomas. In this study, 31 cases of primary central nervous system lymphomas of the diffuse large B-cell type were retrieved, reviewed, and immunostained for CD10, Bcl-6, MUM1, and Ki-67. Subclassification was carried out as described earlier, where CD10 and/or Bcl-6 positivity and negativity for MUM1 were considered characteristic of germinal center subtype and the opposite expression of nongerminal center subtype. Furthermore, the proliferative activity was semiquantitatively assessed using percent positive cells staining with Ki-67. Of the 31 cases examined, 26 (84%) were found to belong to the nongerminal center type. The Ki-67 index in these 26 cases ranged from 30 to 90% (mean, 69%). Five cases were categorized as the germinal center subtype. They had an Ki-67 index between 70 and 90% (mean, 78%). Interestingly, none of our patients were known to be HIV positive. One patient had a 10-year history of orthotopic liver transplant. We also performed fluorescence in situ hybridization analysis on formalin-fixed material and found that 38% of the cases where tissue was available had abnormalities of MYC/ IGH and/or IGH/BCL2. We conclude that most primary central nervous system diffuse large B-cell lymphomas are of the nongerminal center origin. Regardless of the germinal center status, all cases showed a high proliferative rate. A statistically significant difference in the overall survival between the two groups was not seen.

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Epidemiology of Brain Lymphoma Among People With or Without Acquired Immunodeficiency Syndrome

Abstract: This study emphasizes a greater need to bring health care resources to this burgeoning epidemic.

Cited by 218 publications

References 7 publications

Primary intramedullary spinal cord lymphoma: a population-based study

Primary intramedullary spinal cord lymphoma: a population-based study

Expression of B-cell–attracting chemokine 1 (CXCL13) by malignant lymphocytes and vascular endothelium in primary central nervous system lymphoma

Most primary central nervous system diffuse large B-cell lymphomas occurring in immunocompetent individuals belong to the nongerminal center subtype: a retrospective analysis of 31 cases

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