Primary central nervous system lymphoma with clonal bone marrow B cells:16 cases and literature review
10.3969/j.issn.1672-8467.2025.01.012
- VernacularTitle:原发性中枢神经系统淋巴瘤伴骨髓克隆性B细胞16例并文献复习
- Author:
Yu-nan LING
1
;
Jing-jing MA
1
;
Zhi-guang LIN
1
;
Yan MA
1
;
Qing LI
1
;
Hui KANG
1
;
Meng-xue ZHANG
1
;
Bo-bin CHEN
1
Author Information
1. 复旦大学附属华山医院血液科 上海 200040
- Publication Type:Journal Article
- Keywords:
primary central nervous system lymphoma(PCNSL);
clonal bone marrow B cells;
common precursor cells;
prognosis
- From:
Fudan University Journal of Medical Sciences
2025;52(1):91-98
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the clinical features,treatment and prognosis of patients with primary central nervous system lymphoma(PCNSL)with clonal bone marrow B cells,and to explore the influence on clinical diagnosis and treatment.Methods PCNSL patients with clonal bone marrow B cells diagnosed by flow cytometry between Jan 2020 and Jul 2023 at Huashan Hospital of Fudan University were enrolled.The auxiliary examination data of these patients were collected,including complete blood count,routine biochemistry,bone marrow aspiration and biopsy,contrast-enhanced brain MRI,and whole-body PET-CT.Kaplan-Meier was used to draw the survival curve,and relevant literature was reviewed.Results A total of 223 newly diagnosed PCNSL patients were included,187 of whom completed bone marrow puncture and biopsy evaluation.We found clonal bone marrow B cells in 16 of 187 cases(8.56%)by flow cytometry.2 patients showed B lymphoma involving the bone marrow.All patients received a high-dose methotrexate based chemotherapy.The median progression free survival(PFS)of 16 patients with clonal bone marrow B cells was 11.1 months,and the median PFS of 171 patients with normal bone marrow was 12.6 months.There was no significant difference in the PFS between the two groups.Conclusion PCNSL with clonal bone marrow B cells had no specific clinical features,but bone marrow flow cytometry showed clonal B cells.High-dose methotrexate treatment regimen is effective.There was no significant difference in PFS for PCNSL patients with clonal B cells and normal findings in bone marrow.Clonal B cells in bone marrow may be caused by monoclonal B-cell lymphocytosis(MBL),lymphoma involves the bone marrow and the presence of common precursor cells.Bone marrow examination should be performed in the initial evaluation of suspected PCNSL.
