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Treatment strategies and prognostic factors in secondary central nervous system lymphoma: a multicenter study of 124 patients

Secondary central nervous system lymphoma (SCNSL) is a rare and difficult to treat type of Non-Hodgkin lymphoma characterized by systemic and central nervous system (CNS) disease manifestations. In this study, 124 patients with SCNSL intensively treated and with clinical long-term follow-up were inc...

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Main Authors: Treiber, Hannes (Author) , Nilius-Eliliwi, Verena (Author) , Seifert, Nicole (Author) , Vangala, Deepak (Author) , Wang, Meng (Author) , Seidel, Sabine (Author) , Mika, Thomas (Author) , Marschner, Dominik (Author) , Zeremski, Vanja (Author) , Wurm-Kuczera, Rebecca (Author) , Caillé, Léandra (Author) , Chapuy, Claudia I. (Author) , Trümper, Lorenz (Author) , Fischer, Thomas (Author) , Altenbuchinger, Michael Christoph (Author) , Wulf, Gerald (Author) , Illerhaus, Gerald (Author) , Dietrich, Sascha (Author) , Schroers, Roland (Author) , Chapuy, Björn (Author)
Format: Article (Journal)
Language:English
Published: August 2023
In: HemaSphere
Year: 2023, Volume: 7, Issue: 8, Pages: 1-12
ISSN:2572-9241
DOI:10.1097/HS9.0000000000000926
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1097/HS9.0000000000000926
Verlag, lizenzpflichtig, Volltext: https://journals.lww.com/hemasphere/fulltext/2023/08000/treatment_strategies_and_prognostic_factors_in.9.aspx
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Author Notes:Hannes Treiber, Verena Nilius-Eliliwi, Nicole Seifert, Deepak Vangala, Meng Wang, Sabine Seidel, Thomas Mika, Dominik Marschner, Vanja Zeremski, Rebecca Wurm-Kuczera, Leandra Caillé, Claudia I. Chapuy, Lorenz Trümper, Thomas Fischer, Michael Altenbuchinger, Gerald G. Wulf, Gerald Illerhaus, Sascha Dietrich, Roland Schroers, Björn Chapuy
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Summary:Secondary central nervous system lymphoma (SCNSL) is a rare and difficult to treat type of Non-Hodgkin lymphoma characterized by systemic and central nervous system (CNS) disease manifestations. In this study, 124 patients with SCNSL intensively treated and with clinical long-term follow-up were included. Initial histopathology, as divided in low-grade, other aggressive, and diffuse large B-cell lymphoma (DLBCL), was of prognostic significance. Overall response to induction treatment was a prognostic factor with early responding DLBCL-SCNSL in comparison to those non-responding experiencing a significantly better progression-free survival (PFS) and overall survival (OS). However, the type of induction regime was not prognostic for survival. Following consolidating high-dose chemotherapy and autologous stem cell transplantation (HDT-ASCT), DLBCL-SCNSL patients had better median PFS and OS. The important role of HDT-ASCT was further highlighted by favorable responses and survival of patients not responding to induction therapy and by excellent results in patients with de novo DLBCL-SCNSL (65% long-term survival). SCNSL identified as a progression of disease within 6 months of initial systemic lymphoma presentation represented a previously not appreciated subgroup with particularly dismal outcome. This temporal stratification model of SCNSL diagnosis revealed CNS progression of disease within 6 months as a promising candidate prognosticator for future studies.
Item Description:Gesehen am 29.08.2023
Physical Description:Online Resource
ISSN:2572-9241
DOI:10.1097/HS9.0000000000000926

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