Recent advances in the diagnosis and the treatment of primary CNS lymphoma

Rachdi, Amine; Hernández-Tost, H; Herzi, D; Morales-Martínez, Andrea; Hernández-Verdin, Isaias; Houillier, Caroline; Alentorn, Agustí; Hoang-Xuân, Khê

doi:10.1016/j.neurol.2023.03.012

Cited by 8 publications

(2 citation statements)

References 74 publications

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“…Autologous hematopoietic thousand cell transplantation may also be used as a consolidation therapy if remission is achieved. Immunotherapy, signaling pathway blocking and other therapies were used to rescue the recurrent and refractory PCNSL [30].…”

Section: Treatment Of Refractory and Relapsed(r/r) Pcnslmentioning

confidence: 99%

A systematic review of primary central nervous system lymphoma

Zhang,

Zhang

2024

Holist Integ Oncol

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Primary central nervous system lymphoma is a kind of extranodal lymphoma with high degree of malignancy, hidden onset and strong invasion. It is a special type of non-Hodgkin’s lymphoma and very rare in clinic. Due to little understanding of the pathogenesis and high risk factors of the disease, there are great differences in the prevention, staging and treatment plan of the disease, and there is no strict standard. In this review, we aim to comprehensively summarize the clinical characteristics of PCNSL and the promising clinical treatment strategies for PCNSL to date.

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Section: Treatment Of Refractory and Relapsed(r/r) Pcnslmentioning

confidence: 99%

A systematic review of primary central nervous system lymphoma

Zhang,

Zhang

2024

Holist Integ Oncol

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“…This includes systemic chemotherapy and immunotherapy, as well as consolidation treatment when necessary. 13,14 In previously published retrospective series, it was reported that a substantial proportion of patients who have been diagnosed with PCNSL have developed seizures, with an incidence ranging from 0% to 33%. 15,16 Notably, seizures tend to emerge as initial symptom of the disease.…”

Section: Introductionmentioning

confidence: 99%

Epilepsy in Patients With Primary CNS Lymphoma

Aboubakr,

Houillier,

Alentorn

et al. 2024

Neurology

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Background and ObjectivesEpilepsy is a common comorbidity of brain tumors; however, little is known about the prevalence, onset time, semiology, and risk factors of seizures in primary CNS lymphoma (PCNSL). Our objectives were to determine the prevalence of epilepsy in PCNSL, to identify factors associated with epilepsy, and to investigate the prognostic significance of seizures in PCNSL.MethodsWe performed an observational, retrospective single-center study at a tertiary neuro-oncology center (2011–2023) including immunocompetent patients with PCNSL and no history of seizures. We collected clinical, imaging, and treatment data; seizure status over the course of PCNSL; and oncological and seizure outcome. The primary outcome was to determine the prevalence of epilepsy. Furthermore, we aimed to identify clinical, radiologic, and treatment-related factors associated with epilepsy. Univariate analyses were conducted using the χ2 test for categorical variables and unpaired t test for continuous variables. Predictors identified in the unadjusted analysis were included in backward stepwise logistic regression models.ResultsWe included 330 patients, 157 (47.6%) were male, median age at diagnosis was 68 years, and the median Karnofsky Performance Status score was 60. Eighty-three (25.2%) patients had at least 1 seizure from initial diagnosis to the last follow-up, 40 (12.1%) as the onset symptom, 16 (4.8%) during first line of treatment, 27 (8.2%) at tumor progression and 6 (1.8%) while in remission. Focal aware seizures were the most frequent seizure type, occurring in 43 (51.8%) patients. Seizure freedom under antiseizure medication was observed in 97.6% patients. Cortical contact (odds ratio [OR] 8.6, 95% CI 4.2–15.5, p < 0.001) and a higher proliferation index (OR 5.7, 95% CI 1.3–26.2, p = 0.02) were identified as independent risk factors of epilepsy. Patients with PCNSL and epilepsy had a significantly shorter progression-free survival (median progression-free survival 9.6 vs 14.1 months, adjusted hazard ratio 1.4, 95% CI 1.0–1.9, p = 0.03), but not a significantly shorter overall survival (17 vs 44.1 months, log-rank test, p = 0.09).DiscussionEpilepsy affects a quarter of patients with PCNSL, with half experiencing it at the time of initial presentation and potentially serving as a marker of disease progression. Further research is necessary to assess the broader applicability of these findings because they are subject to the constraints of a retrospective design and tertiary center setting.

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