Primary Central Nervous System Lymphoma: Clinical Characteristics, Treatment Options and Therapeutic Outcome in 36 Patients. A Single Center Experience.

作者：Miri Zektser, Anat Rabinovich, Uri Grinbaum, Tzvi Porges, Aya Gozlan, Anna Gourevitch, Kayed Al-Athamen, Orit Barrett, Ido Peles, Tehila Kaisman‐Elbaz, Etai Levi · 发表于：PubMed · 年份：2022 · 被引用次数：2 · 研究领域：CNS Lymphoma Diagnosis and Treatment、Lymphoma Diagnosis and Treatment、Lymphadenopathy Diagnosis and Analysis

BACKGROUND: Primary central nervous system lymphoma (PCNSL) is a rare aggressive non-Hodgkin's lymphoma. There are limited data on the management of PCNSL outside of clinical trials. OBJECTIVES: To report experience with three main high-dose methotrexate (HDMTX)-based protocols for PCNSL treatment at one medical center. METHODS: We conducted a retrospective review of the medical records of patients diagnosed with PCNSL who were treated at Soroka Medical Center between 2007 and 2019. RESULTS: The study included 36 patients, median age 64.9 years; 33 patients received a HDMTX backbone induction therapy, 21 (58.3%) received consolidation treatment in addition. In the entire cohort, 25 patients (75.7%) achieved complete remission (CR, CRu-unconfirmed), with mean progression-free survival (PFS) 32 ± 6.9 months and median overall survival (OS) 59.6 ± 12.4 months. More aggressive regiment such as combination of rituximab, HDMTX, cytarabine and thiotepa had better responses 5 (100%) CR, but also a higher incidence of side effects such as neutropenic fever 5 (100%). In subgroup analysis by age (younger vs. older than 60 years), the PFS was 24.2 vs. 9.3 months, and OS was 64.1 vs. 19.4 months, respectively. CONCLUSIONS: A difference in CR and PFS favored a more aggressive protocol, but the toxicity of the multiagent combinations was significantly higher. The prognosis in younger was better than in older patients, with higher rates of CR, PFS, and OS, although not statistically signific...