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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| Hauptverfasser: | , , , , , , , , , , , , , , , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
August 2023
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| In: |
HemaSphere
Year: 2023, Jahrgang: 7, Heft: 8, Pages: 1-12 |
| ISSN: | 2572-9241 |
| DOI: | 10.1097/HS9.0000000000000926 |
| Online-Zugang: | 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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| Verfasserangaben: | 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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| 520 | |a 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. | ||
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