Primary CNS lymphoma: A review of clinicopathologic characteristics, therapy, and outcomes of 54 patients with primary CNS DLBCL
| Autor: | Vu H. Duong, Nalini Hasija, Eduardo M. Sotomayor, M. Tomblyn, Lubomir Sokol, Edward Pan, Peter A. Forsyth, Michael Jaglal, Celeste M. Bello |
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| Rok vydání: | 2012 |
| Předmět: | |
| Zdroj: | Journal of Clinical Oncology. 30:2099-2099 |
| ISSN: | 1527-7755 0732-183X |
| DOI: | 10.1200/jco.2012.30.15_suppl.2099 |
| Popis: | 2099 Background: Primary central nervous system lymphoma (PCNSL) is a rare aggressive variant of diffuse large B cell lymphoma (DLBCL) with a poor prognosis. Optimal therapeutic strategies have not yet been defined. High dose methotrexate (HD MTX) is an effective chemotherapeutic agent with superior outcomes compared to historical studies using whole brain radiation therapy (WBRT). Purpose: To review clinicopathologic characteristics, therapy and outcomes of 54 patients (pts) with primary CNS DLBCL. Methods: This was a single center retrospective review of pts with confirmed diagnosis of primary CNS DLBCL from 1999 to 2009. Data was extracted from the Moffitt Cancer Center (MCC) electronic records. Baseline demographics, clinical, pathological and treatment data were collected and analyzed. Pts were stratified according to their treatment regimens including HD MTX (8g/m2) alone or in combinations and WBRT alone or in combination with CT. Descriptive statistical analyses were utilized. Chi square analysis and t- test were performed to compare categorical and continuous variables. Kaplan-Meier method was used to estimate OS and log rank test was used to compare the groups. All data was analyzed using SPSS version 20.0 statistical software. Results: 54 pts who underwent CT and/or WBRT for PCNSL between 1999 and 2009 were identified. The age range at diagnosis was 19-85 years with median age of 63. 31 of 54 pts (57%) were ≥ 60 years old. Male to female ratio was 1.25 :1 (30:24). The median ECOG PS was 1. Only 2 pts had HIV. A majority of pts presented with motor deficits. The most common location of lymphoma was in the cerebral hemispheres. The median survival of the entire cohort was 42 months. 15 of 54 pts (23%) survived ≥ 60 months. In the cohort of pts that survived ≥ 60 months, a majority 11 of 15 (73%) received HD MTX. Pts treated with initial WBRT revealed inferior overall survival (OS) compared to pts treated with induction CT (OS 37 months vs. 50 months) (p=0.056). Conclusions: HD MTX was the most frequently utilized CT regimen in the cohort of pts surviving > 60 months. Administering WBRT as an initial modality was associated with worse outcomes in this retrospective analysis. |
| Databáze: | OpenAIRE |
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