Beer Sina A, Wirths Stefan, Vogel Wichard, Tabatabai Ghazaleh, Ernemann Ulrike, Merle David A, Bethge Wolfgang, Möhle Robert, Lengerke Claudia
Department of Internal Medicine II, Hematology, Oncology, Clinical Immunology and Rheumatology, University Hospital Tübingen, 72076 Tübingen, Germany.
Department of Neurology and Interdisciplinary Neuro Oncology, Hertie Institute for Clinial Brain Research, University Hospital Tübingen, 72076 Tübingen, Germany.
Cancers (Basel). 2023 Jan 21;15(3):669. doi: 10.3390/cancers15030669.
Primary central nervous system lymphomas (PCNSL) are rare and associated with an adverse prognosis. High-dose chemotherapy followed by autologous stem cell transplantation (HDC/ASCT) improves progression free (PFS) and overall survival (OS) but neurocognition, performance status and quality of life (QoL) in patient-reported outcome (PRO) after HDC/ASCT remains underexplored. Especially elderly patients may insufficiently recover from this demanding therapy. Therefore, this single-center analysis investigated all PCNSL patients who received HDC/ASCT at the University Hospital Tübingen from 2006-2021 ( = 40, median age 60.5 years) in a retrospective manner. The 2-year PFS/OS was 78.7%/77.3%, respectively, without significant differences between the tested age-groups (≤60 vs. >60 years, = 0.531/ = 0.334). Higher Thiotepa dosage was an independent predictor for better OS ( = 0.018). Additionally, a one-time prospective, cross-sectional analysis after HDC/ASCT in the same cohort was performed ( = 31; median follow-up 45 months). Here, the median ECOG improved by HDC/ASCT from 1 to 0 and mini-mental state examinations revealed unimpaired neurocognitive functioning (median 28 pts.). PRO data collected by EORTC QLQ-C30 showed a good QoL in both age groups with an average global health status (GHS) of 68.82% (≤60y: 64.72%, >60y: 74.14%). Together, our data indicate that HDC/ASCT is an effective therapy with respect to disease control, overall health status and quality of life, irrespective of patient age.
原发性中枢神经系统淋巴瘤（PCNSL）较为罕见，预后不良。大剂量化疗联合自体干细胞移植（HDC/ASCT）可改善无进展生存期（PFS）和总生存期（OS），但HDC/ASCT后患者报告结局（PRO）中的神经认知、功能状态和生活质量（QoL）仍未得到充分研究。尤其是老年患者可能无法从这种高要求的治疗中充分恢复。因此，本单中心分析对2006年至2021年在图宾根大学医院接受HDC/ASCT的所有PCNSL患者（n = 40，中位年龄60.5岁）进行了回顾性研究。2年PFS/OS分别为78.7%/77.3%，各测试年龄组（≤60岁与>60岁）之间无显著差异（P = 0.531/P = 0.334）。硫替派剂量较高是OS较好的独立预测因素（P = 0.018）。此外，对同一队列在HDC/ASCT后进行了一次前瞻性横断面分析（n = 31；中位随访45个月）。在此，HDC/ASCT使中位东部肿瘤协作组（ECOG）评分从1改善至0，简易精神状态检查显示神经认知功能未受损（中位28分）。欧洲癌症研究与治疗组织（EORTC）QLQ-C30收集的PRO数据显示，两个年龄组的生活质量均良好，平均总体健康状况（GHS）为68.82%（≤60岁：64.72%，>60岁：74.14%）。总体而言，我们的数据表明，无论患者年龄如何，HDC/ASCT在疾病控制、总体健康状况和生活质量方面都是一种有效的治疗方法。
