Department of Hematology, the Second Affiliated Hospital, Zhejiang University School of Medicine, #88 Jiefang Road, Hangzhou, 310009, China.
Department of Neurosurgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, #88 Jiefang Road, Hangzhou, 310009, China.
Ann Hematol. 2020 Jan;99(1):93-104. doi: 10.1007/s00277-019-03821-9. Epub 2019 Nov 22.
Primary central nervous system lymphoma (PCNSL) is a rare form of extranodal non-Hodgkin's lymphoma and a limited number of cases have been reported from China. This study aimed to investigate the clinicopathological features of newly diagnosed PCNSLs from a single center in eastern China and to identify the potential prognostic factors for overall survival (OS) and progression-free survival (PFS). All consecutive patients with histopathologically diagnosed PCNSLs at our center between January 2003 and October 2017 were recruited. Demographic and clinicopathological data were collected and reviewed retrospectively. The potential risk factors for OS and PFS were identified using the log-rank test and Cox regression analysis. A total of 167 immunocompetent cases were enrolled. The median age was 58 years (range 17-96 years), and the male:female ratio was 3:2. Headache (n = 65; 39%) and cerebral hemisphere (n = 96; 57%) were the most common presenting complaint and location, respectively. Out of 167 cases, 150 cases were diffuse large B cell lymphomas. With a median follow-up of 25 months (range 1-152 ), the median OS and PFS were 37 months (95% CI, 25-49) and 17 months (95% CI, 13-20), respectively. Residual tumor after operation, chemotherapy without HD-MTX and palliative treatment was revealed as independent prognostic markers. Moreover, ECOG > 3, multifocal lesions, and palliative treatment were revealed as unfavorable independent prognostic markers for PFS. In conclusion, Chinese patients with PCNSL have distinct characteristics. Further studies are warranted to confirm the prognostic value of these factors and to optimize treatments for these patients.
原发性中枢神经系统淋巴瘤（PCNSL）是一种罕见的结外非霍奇金淋巴瘤，中国仅有少数病例报道。本研究旨在探讨中国东部某单一中心新诊断的 PCNSL 的临床病理特征，并确定总生存期（OS）和无进展生存期（PFS）的潜在预后因素。回顾性收集了 2003 年 1 月至 2017 年 10 月在本中心经组织病理学诊断为 PCNSL 的所有连续患者。收集了人口统计学和临床病理数据，并进行了回顾性分析。使用对数秩检验和 Cox 回归分析确定 OS 和 PFS 的潜在危险因素。共纳入 167 例免疫功能正常的病例。中位年龄为 58 岁（范围 17-96 岁），男女比例为 3:2。头痛（n=65；39%）和大脑半球（n=96；57%）是最常见的首发症状和部位。在 167 例病例中，150 例为弥漫性大 B 细胞淋巴瘤。中位随访时间为 25 个月（范围 1-152），中位 OS 和 PFS 分别为 37 个月（95%CI，25-49）和 17 个月（95%CI，13-20）。术后残余肿瘤、未使用 HD-MTX 的化疗和姑息治疗被揭示为独立的预后标志物。此外，ECOG>3、多发病灶和姑息治疗被揭示为 PFS 的不利独立预后标志物。总之，中国 PCNSL 患者具有独特的特征。需要进一步的研究来证实这些因素的预后价值，并优化这些患者的治疗。
