Primary central nervous system lymphoma: a new prognostic model for patients with diffuse large B-cell histology

Ahn, Yongchel; Ahn, Heui June; Yoon, Dok Hyun; Hong, Jung Yong; Yoo, Changhoon; Kim, Shin; Huh, Jooryung; Suh, Cheolwon

doi:10.5045/br.2017.52.4.285

Cited by 21 publications

(21 citation statements)

References 20 publications

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“…also established the role of serum LDH level in predicting PCNSL survival within six months 18. However, results from two large cohorts were inconsistent with the aforementioned findings, thereby raising questions in terms of the prognostic value of serum LDH level for survival 16, 41. In current study, heightened LDH serum level, was also not identified as a risk factor for early mortality within 60 days in either univariate or multivariate analysis.…”

Section: Discussioncontrasting

confidence: 57%

Risk Prediction for Early Mortality in Patients with Newly Diagnosed Primary CNS Lymphoma

Lin

Yang

et al. 2019

J. Cancer

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Background: Overall survival of patients with primary CNS lymphoma (PCNSL) has improved since the introduction of immunochemotherapy. However, up to 10-15% of PCNSL patients still die shortly after diagnosis. In the present study, we aimed to investigate the risk factors of early mortality (death within 60 days after diagnosis) in patients with PCNSL. Methods: We included newly diagnosed PCNSL patients in a tertiary medical center in Taiwan between January 1, 2002 and May 31, 2018. Clinical risk factors were collected and compared between PCNSL patients who had and did not have early mortality. Results: A total of 133 consecutive patients with PCNSL were included in this study. Approximately 9.8% of the PCNSL patients had early mortality. In multivariate analysis, age ≥ 80 (adjusted hazard ratio [HR] 3.34, 95% confidence interval [CI] 1.01-11.04, p = 0.048) and involvement of the basal ganglia (adjusted HR 4.85, 95% CI 1.47-15.95, p = 0.009) were identified as independent risk factors of early mortality. Use of MTX-based chemotherapy served as an independent protective factor for early mortality (adjusted HR 0.19, 95% CI 0.05-0.67, p = 0.010). Infection and tumor-associated mass effect contributed most to early mortality. Conclusion: Early mortality is not uncommon in patients with PCNSL. Identification of patients with higher risk may help clinicians with initiating appropriate surveillance and management.

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Section: Discussioncontrasting

confidence: 57%

Risk Prediction for Early Mortality in Patients with Newly Diagnosed Primary CNS Lymphoma

Lin

Yang

et al. 2019

J. Cancer

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“…The mean age at diagnosis was 63.1±14.9 years, and the male to female ratio was 1.1:1.0, which was largely consisting with population-based study from Australia [10]. Previous studies have demonstrated that age was a signi cant and adverse prognostic factor [11][12][13]. In the present study, inferior OS and DSS were signi cantly associated with older age, consisting with previous results.…”

Section: Discussionsupporting

confidence: 86%

Epidemiologic Characteristics, Prognostic Factors and Treatment Outcomes in Primary Central Nervous System Lymphoma: A SEER-Based Study

Dongsheng¹,

Chen²,

Shi³

et al. 2021

Preprint

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Objective: To study the clinical characteristics, prognostic factors and treatment outcomes in patients with primary central nervous system lymphoma (PCNSL).Materials and Methods: The data of total 5166 PCNSL patients diagnosed between 2000 and 2018 from the Surveillance, Epidemiology, and End Results (SEER) database was obtained.Results: The mean age was 63.1±14.9 years, with a male to female of 1.1:1.0. The most common histologic subtype was diffuse large B-cell lymphoma (DLBCL) (84.6%). The 1-, 3-, and 5-year OS were 50.1, 36.0 and 27.2% and corresponding to DSS were 54.4, 41.3 and 33.5%, respectively. Multivariate analysis with Cox regression showed that race, sex, age, marital status, surgery, chemotherapy and radiotherapy were independent prognostic factors for OS, but radiotherapy no longer for DSS. Nomograms specially for DLBCL were established to predict the possibility of OS and DSS. The concordance index (C-index) of OS and DSS were 0.704 (95% CI 0.687-0.721) and 0.698 (95% CI 0.679-0.717), suggesting the high discrimination ability of the nomograms.Conclusion: Surgery or/and chemotherapy was favourably associated with better OS and DSS. However, radiotherapy did not benefit to OS and DSS in the long-term. A new predictive nomogram and a web-based survival rate calculator we developed showed favorable applicability and accuracy to predict the long-term OS for DLBCL patients specifically.

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“…The main symptoms of PCNSL are changes in mental state and intracranial hypertension such as headache, nausea and vomiting, papilledema, and local compression symptoms, including epilepsy, memory loss, unstable gait, visual impairment, blurred speech, and mild haemiplegia. In addition to brain damage, 10%~ 20% of patients have eye damage characterised by blurred vision or floating objects [2]. Because of the multifocal characteristics, the clinical manifestations of lymphoma patients may vary, making the disease difficult to diagnose [3].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, with the use of glucocorticoid before examination, the detection rate is significantly reduced. Therefore, the diagnosis of PCNSL is challenging, and most cases are misdiagnosed [5, 6].…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of central nervous system lymphoma via cerebrospinal fluid cytology: a case report

Zhao

Zhang

et al. 2019

BMC Neurol

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Background Primary central nervous system lymphoma (PCNSL) is the most prevalent brain, spinal cord, eyes, and leptomeningeal lymphoma. It is often misdiagnosed due to an unspecific presentation or unavailable biopsy and results in a poor prognosis. Although the craniocerebral imaging examination of PCNSL has some characteristics, it is limited, and atypical cases are especially difficult to identify with intracranial tumours and other diseases. The biopsy, as the gold standard for PCNSL diagnosis, is not eligible for all patients suspected of having PCNSL. Case presentation This report documents a woman who presented with a three-month history of numbness and weakness in the right leg. She was treated with drugs at a local hospital for one month. She developed demyelination lesions and her symptoms were aggravated. The patient was admitted to the Department of Nerve Infection and Immunology at Tiantan Hospital. Head magnetic resonance imaging (MRI) enhanced scanning indicated significant inflammatory demyelinating disease, and lymphoma was not excluded. CSF revealed a high protein level and CSF cytology detected abnormal cells, PCNSL was eventually presumed according to positive CSF cytology and cytological detection of the cerebrospinal fluid flow. Conclusions PCNSL is a highly invasive tumour. With the development of technologies such as cerebrospinal fluid cytology and flow cytology, CSF analysis has become one of the definite diagnosis methods, and the tumour cell finding in CSF is the only reliable basis for diagnosis. Flow cytometric analysis and gene rearrangement testing also provide objective evidence.

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Primary central nervous system lymphoma: a new prognostic model for patients with diffuse large B-cell histology

Cited by 21 publications

References 20 publications

Risk Prediction for Early Mortality in Patients with Newly Diagnosed Primary CNS Lymphoma

Risk Prediction for Early Mortality in Patients with Newly Diagnosed Primary CNS Lymphoma

Epidemiologic Characteristics, Prognostic Factors and Treatment Outcomes in Primary Central Nervous System Lymphoma: A SEER-Based Study

Diagnosis of central nervous system lymphoma via cerebrospinal fluid cytology: a case report

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