Clinical features and treatment outcomes in primary central nervous system lymphoma: a descriptive analysis of 62 patients
10.3760/cma.j.issn.0529?5807.2019.11.006
- VernacularTitle:原发性中枢神经系统淋巴瘤62例临床病理学特征及预后
- Author:
Yan GE
1
;
Xingtao LIN
;
Donglan LUO
;
Fen ZHANG
;
Jie XU
;
Zhi LI
;
Yanhui LIU
Author Information
1. 广东省人民医院广东省医学科学院病理医学部病理科
- Keywords:
Central nervous system neoplasms;
Lymphoma,B?cell;
Lymphoma,large B?cell,diffuse;
Prognosis
- From:
Chinese Journal of Pathology
2019;48(11):861-866
- CountryChina
- Language:Chinese
-
Abstract:
assess clinical features and treatment outcomes in immunocompetent patients with primary central nervous system lymphoma (PCNSL). Methods Sixty?two patients with PCNSL who attended Guangdong General Hospital between January 1998 and January 2012 were included. Survival curves were estimated using Kaplan?Meier survival methodology and statistical significance of continuous was assessed via the Cox proportional hazard model. Results The median age of the patient cohort was 56 years, and the male to female ratio was 1.14∶1.00. The common presentations were increased intracranial pressure symptoms and neuron damage. Performance status of 54 (54/62, 87.1%) patients were the international prognostic index (IPI) 0-2. Diffuse large B?cell lymphoma (57/62, 91.9%) was most common, and the rest were T?cell lymphoma (4/62, 6.4%) and extranodal marginal zone lymphoma of mucosa?associated lymphoid tissue (1/62, 1.6%). In the series, 32 patients (32/62, 51.6%) had multiple lesions. Involvement of deep structures was found in 30 (30/62, 48.4%) patients. An elevated serum LDH level was detected in 19 (19/62, 30.6%) patients and the Ki?67 index was ≥90% in 38 (38/62, 61.3%) patients. Univariate analysis showed patients who were female, age<60 years, had WHO Eastern Cooperative Oncology Group performance status grade 0-2, single lesion, absence of deep structures involvement and normal LDH level showed better 2?year survival rate and longer median survival time. Significance was only seen in the normal LDH level group. Multivariate Cox regression analysis revealed that radical surgery only and Rituximab+ high?dose of methotrexate+ whole brain radiation therapy (WBRT) were independent prognostic indicators in PCNSL patients (P<0.05). Conclusions PCNSL is a rare but aggressive tumor with poor prognosis. Patients treated with high?dose of methotrexate combining with rituximab, followed by WBRT have a better prognosis and longer survival time, and thus these could probably be a promising treatment.
