Treatment Strategies and Prognostic Factors in Secondary Central Nervous System Lymphoma: A Multicenter Study of 124 Patients
2023-08 | journal article. A publication with affiliation to the University of Göttingen.
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Treatment Strategies and Prognostic Factors in Secondary Central Nervous System Lymphoma: A Multicenter Study of 124 Patients
Treiber, H.; Nilius-Eliliwi, V.; Seifert, N.; Vangala, D.; Wang, M.; Seidel, S. & Mika, T. et al. (2023)
HemaSphere, 7(8) pp. e926. DOI: https://doi.org/10.1097/HS9.0000000000000926
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Details
- Authors
- Treiber, Hannes; Nilius-Eliliwi, Verena; Seifert, Nicole; Vangala, Deepak; Wang, Meng; Seidel, Sabine; Mika, Thomas; Marschner, Dominik; Zeremski, Vanja; Wurm-Kuczera, Rebecca; Caillé, Leandra; Chapuy, Claudia I. ; Trümper, Lorenz; Fischer, Thomas; Altenbuchinger, Michael; Wulf, Gerald G.; Illerhaus, Gerald; Dietrich, Sascha; Schroers, Roland; Chapuy, Björn
- Abstract
- 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.
- Issue Date
- August-2023
- Journal
- HemaSphere
- Organization
- Klinik für Hämatologie und Medizinische Onkologie ; Universitätsmedizin Göttingen
- ISSN
- 2572-9241
- eISSN
- 2572-9241
- Language
- English