Qiu Zicong, Tang Yongshi, Jiang Yanting, Su Miao, Wang Xuemin, Xu Xiuhong, Chen Yuerong
First School of Clinical Medicine, Guangzhou Medical University, Guangzhou, China.
Second School of Clinical Medicine, Guangzhou Medical University, Guangzhou, China.
Front Oncol. 2021 Jul 5;11:691038. doi: 10.3389/fonc.2021.691038. eCollection 2021.
Primary central nervous system lymphoma (PCNSL) is a rare but highly aggressive non-Hodgkin lymphoma. Treatment-related cardiovascular lesion has become one of the most common complications in patients with tumor. However, very little is known about the cardiovascular death (CVD) of the patients with PCNSL. This study aims at identifying the cardiovascular outcomes of PCNSL patients and making comparison on CVD with extra central nervous system lymphoma (ECNSL). Clinical information of PCNSL and ECNSL was retrieved from the Surveillance, Epidemiology and End Results database. The risk factors of CVD in PCNSL patients and the comparison on the CVD hazard between PCNSL and ECNSL were assessed with the competing risks regression. A 1:2 propensity score matching was used to reduce the imbalanced baseline characteristics between PCNSL and ECNSL. Four thousand thirty-eight PCNSL subjects and 246,760 ECNSL subjects were enrolled in this retrospective study. CVD was the leading cause (41.2%) of non-cancer death in PCNSL patients and mostly occurred within the first year of diagnosis. Age over 60s and diagnosis in 2000-2008 were significantly associated with the elevated risk of CVD in PCNSL patients, while chemotherapy and radiotherapy play no role on the cardiovascular outcomes. Compared with ECNSL patients, the risk of CVD in PCNSL patients were 40% approximately lower. The risk of CVD in the patients with PCNSL still remains unclear currently. Clinicians ought to pay more attention on the risk of CVD in PCNSL patients, especially the elder patients within the first year of diagnosis.
原发性中枢神经系统淋巴瘤（PCNSL）是一种罕见但侵袭性很强的非霍奇金淋巴瘤。治疗相关的心血管病变已成为肿瘤患者最常见的并发症之一。然而，对于PCNSL患者的心血管死亡（CVD）知之甚少。本研究旨在确定PCNSL患者的心血管结局，并将CVD与中枢神经系统外淋巴瘤（ECNSL）进行比较。从监测、流行病学和最终结果数据库中检索PCNSL和ECNSL的临床信息。采用竞争风险回归评估PCNSL患者CVD的危险因素以及PCNSL和ECNSL之间CVD风险的比较。采用1:2倾向评分匹配来减少PCNSL和ECNSL之间基线特征的不平衡。本回顾性研究纳入了4038例PCNSL患者和246760例ECNSL患者。CVD是PCNSL患者非癌症死亡的主要原因（41.2%），且大多发生在诊断后的第一年内。60岁以上以及2000 - 2008年诊断与PCNSL患者CVD风险升高显著相关，而化疗和放疗对心血管结局无影响。与ECNSL患者相比，PCNSL患者的CVD风险约低40%。目前PCNSL患者的CVD风险仍不明确。临床医生应更加关注PCNSL患者的CVD风险，尤其是诊断后第一年内的老年患者。
