Long‐term outcomes of frontline intensification in primary <scp>CNS</scp> lymphoma: A real‐world single‐center experience

Wang, Hao-Yuan; Yang, Ching‐Fen; Liu, Chia‐Jen; Hsiao, Liang‐Tsai; Ko, Po Shen; Liu, Yao‐Chung; Chiou, Tzyy‐Wen; Chen, Po‐Min; Liu, Jin-Hwang; Liu, Chia‐Jen

doi:10.1002/cam4.5607

Cited by 3 publications

(5 citation statements)

References 24 publications

(65 reference statements)

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“…Age of more than 60 years old and bilateral cerebral lesions were independent prognostic factors for PCNSL patients in this study. Our findings on the clinical features of patients with DLBCL-type PCNSL align with previous reports, including a trend towards older age and occurrence in immunocompetent individuals [ 17 , 18 ]. We compared the results with that of the IELSG 32 trial and found that patients in Taiwan with DLBCL-type PCNSL had a higher average age (63 vs. 57 years old) and a worse performance status (ECOG ≥ 2:70% vs. 33%) [ 11 ].…”

Section: Discussionsupporting

confidence: 91%

“…Our study of 124 patients with DLBCL-type PCNSL provided real-world experience on clinical characteristics, treatment response, and outcomes. This is the largest PCNSL series reported in Taiwan [ 17 ]. Patients were mainly older adults (median age 63) with poor ECOG performance status (70.9% ECOG ≥ 2) and a median OS of 27.1 months.…”

Section: Discussionmentioning

confidence: 99%

“…EBV-associated lymphoma accounts for a varying percentage of PCNSL ranging from 4.8% to 13.6% in different studies [ 15 – 17 ]. In our study, 7.2% (9/124) of patients were EBV positive (detected by EBV-encoded small RNAs or serum EBV DNA), but due to a lack of testing in most patients (97 unknown), the data is less reliable.…”

Section: Discussionmentioning

confidence: 99%

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Different patterns of failure in two treatment regimens for primary central nervous system lymphoma, a retrospective analysis of 124 cases in Taiwan

Chuang,

Kuo,

Chang

et al. 2023

Clin Exp Med

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To explore prognostic factors and outcomes of primary central nervous system lymphoma (PCNSL) of diffuse large B-cell lymphoma (DLBCL) in Taiwan, 124 PCNSL-DLBCL patients (from 1995 to 2021) were retrospectively analyzed. Mainly, two treatment modalities including sandwich chemoradiotherapy and modified MATRix regimen were employed in these patients. Overall survival (OS) was determined by log-rank test and time-dependent Cox analysis. Median OS of all patients was 27.1 months. 47 (37.9%) patients who underwent sandwich chemoradiotherapy had a complete remission (CR) rate of 87.2%, median OS of 53.9 months, and progression free survival (PFS) of 42.9 months. 11 (8.9%) patients who underwent modified MATRix regimen had CR rate of 72.7%, median OS of 18.9, and PFS of 11.2 months. There are no significant OS differences between treatment groups or addition of Rituximab. Patients treated with the modified MATRix regimen experienced a higher early mortality rate followed by a survival plateau. IELSG low-risk group had significantly improved OS and PFS than IELSG intermediate- or high-risk group. In multivariant analysis, age > 60 years old and bilateral cerebral lesions are associated with significantly inferior OS. Sandwich chemoradiotherapy demonstrated better early survival and reduced treatment-related toxicity for PCNSL patients compared to the modified MATRix regimen. However, the long-term follow-up revealed a higher rate of treatment failure events in the sandwich chemoradiotherapy group. IELSG and MSKCC scores served as reliable risk assessment models. Incorporating bilateral cerebral lesions as a risk factor further improved risk evaluation.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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Different patterns of failure in two treatment regimens for primary central nervous system lymphoma, a retrospective analysis of 124 cases in Taiwan

Chuang,

Kuo,

Chang

et al. 2023

Clin Exp Med

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“…The reported treatment-related mortality using intensified approaches varies with rates up to 12%. [6][7][8][9][10] Prognostic scoring systems have been developed to better riskstratify patients and assist in the selection of therapeutic strategies.…”

Section: Introductionmentioning

confidence: 99%

“…Some patients will not respond to induction therapy, whereas a substantial proportion of them will develop relevant side effects, leading to treatment discontinuation or even death. The reported treatment‐related mortality using intensified approaches varies with rates up to 12% 6–10 …”

Section: Introductionmentioning

confidence: 99%

Relevance of different prognostic scores in primary CNS lymphoma in the era of intensified treatment regimens: A retrospective, multicenter analysis of 174 patients

Zeremski,

Adolph,

Beer

et al. 2024

European J of Haematology

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ObjectivesTreatment intensification (including consolidative high‐dose chemotherapy with autologous stem cell transplantation [HDT‐ASCT]) significantly improved outcome in primary central nervous system lymphoma (PCNSL) patients.MethodsWe conducted a multicenter, retrospective analysis of newly diagnosed PCNSL patients, treated with intensified treatment regimens. The following scores were evaluated in terms of overall survival (OS) and progression‐free survival (PFS): Memorial Sloan‐Kettering Cancer Center (MSKCC), International Extranodal Lymphoma Study Group (IELSG), and three‐factor (3F) prognostic score. Further, all scores were comparatively investigated for model quality and concordance.ResultsAltogether, 174 PCNSL patients were included. One hundred and five patients (60.3%) underwent HDT‐ASCT. Two‐year OS and 2‐year PFS for the entire population were 73.3% and 48.5%, respectively. The MSKCC (p = .003) and 3F score (p < .001), but not the IELSG score (p = .06), had the discriminatory power to identify different risk groups for OS. In regard to concordance, the 3F score (C‐index [0.71]) outperformed both the MSKCC (C‐index [0.64]) and IELSG (C‐index [0.53]) score. Moreover, the superiority of the 3F score was shown for PFS, successfully stratifying patients in three risk groups, which also resulted in the highest C‐index (0.66).ConclusionThe comparative analysis of established PCNSL risk scores affirm the clinical utility of the 3F score stratifying the widest prognostic spectrum among PCNSL patients treated with intensified treatment approaches.

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Long‐term outcomes of frontline intensification in primary CNS lymphoma: A real‐world single‐center experience

et al. 2023

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Long‐term outcomes of frontline intensification in primary CNS lymphoma: A real‐world single‐center experience

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 3 publications

References 24 publications

Different patterns of failure in two treatment regimens for primary central nervous system lymphoma, a retrospective analysis of 124 cases in Taiwan

Different patterns of failure in two treatment regimens for primary central nervous system lymphoma, a retrospective analysis of 124 cases in Taiwan

Relevance of different prognostic scores in primary CNS lymphoma in the era of intensified treatment regimens: A retrospective, multicenter analysis of 174 patients

Long‐term outcomes of frontline intensification in primary CNS lymphoma: A real‐world single‐center experience

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