Clinical Characteristics and Prognosis of 52 Patients with Primary Central Nervous System Lymphoma: 10-Year Experience from a Single Center Study

BackgroundPrimary central nervous system lymphoma (PCNSL) is an aggressive, rare form of Non-Hodgkin lymphoma. The aim of this study was to report a 10-year experience of PCNSL treatment, to evaluate clinical characteristics and treatment outcomes of these patients.

Methods Clinical and pathologic data of 52 patients with PCNSL admitted to Peking University Third Hospital from January 2013 to December 2023 were collected for retrospective analysis. Survival analysis was performed using the Kaplan-Meier method and log-rank test, and prognosis analysis was conducted using the Cox proportional hazards model.

ResultsAmong 52 patients with PCNSL, 44 received induction therapy with chemotherapy. This included 42 patients who were treated with methotrexate-based induction chemotherapy (20 of whom also received small molecule drugs including Bruton's tyrosine kinase inhibitors and immunomodulators), and 2patients who received other chemotherapy regimens. Of these 44 patients, 32 (72.7%) achieved complete remission (CR) and 7 (15.9%) achieved partial remission (PR). No significant difference in efficacy was observed between patients receiving methotrexate-based induction chemotherapy with or without small molecule drugs. An additional 5 patients were treated with a chemo-free regimen of small molecule drugs, achieving 40% CR and 20% PR. The 2-year progression-free survival (PFS) rate was 56.4%, with a median progression-free survival (mPFS) time of 31 months, while the 2-year overall survival (OS) rate was 75.5%, with a median OS (mOS) time of 79 months. Univariant analysis demonstrated that age over 60 years, International Extranodal Lymphoma Study Group (IELSG) prognostic model, Memorial Sloan-Kettering Cancer Center (MSKCC) prognostic model, and autologous stem cell transplantation (auto-HSCT) were significantly associated with OS in PCNSL patients. Multivariant analysis further indicated that methotrexate-based induction chemotherapy and auto-HSCT were independent favorable prognostic factor for OS.

Conclusions Our study indicated that patients with PCNSL would benefit from methotrexate-based induction chemotherapy and auto-HSCT as consolidation therapy. The efficacy of small molecule drugs in induction therapy still needs more studies to verify.

No relevant conflicts of interest to declare.