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

Media type: E-Article

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

Contributor: 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]

Published: August 2023

Language: English

DOI: 10.1097/HS9.0000000000000926

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Description: 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.

Access State: Open Access

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