From the Departments of Neurooncology (D.H., A.L., A.A., K.H.-X., C.H.), Biological Hematology (M.L.G.-T., E.S.), Clinical Hematology (S.C., I.B.), Neuro-radiology (L.N.), Neurosurgery (B.M.), and Neuropathology (K.M.), Hôpital Pitié-Salpêtrière, Paris; and Clinical Hematology (C.S., M.A.) Institut Curie, Saint Cloud, France.
Neurology. 2024 Jun 25;102(12):e209527. doi: 10.1212/WNL.0000000000209527. Epub 2024 Jun 3.
Despite a high response rate at the first evaluation during induction chemotherapy, the risk of early relapse remains high and unpredictable in primary CNS lymphomas (PCSNLs). We aimed to assess the prognostic value of early IL-10 levels in CSF (e-IL-10) after 2 months of induction chemotherapy.
We retrospectively selected from the LOC (Lymphomes Oculo-Cérébraux) network database patients with PCSNLs who had complete or partial response at the 2-month evaluation of a high-dose methotrexate-based first-line chemotherapy for whom e-IL-10 was available.
Thirty patients (median age: 62 years, brain involvement in 30/30, CSF involvement in 10/30, median baseline CSF IL-10: 27.5 pg/mL) met the selection criteria. e-IL-10 was undetectable in 22 patients and detectable in 8 patients. At the end of induction treatment, 7 of 8 and 4 of 22 of the patients with detectable and undetectable e-IL-10 had experienced progressive disease, respectively ( = 0.001, OR: 26.8, 95% CI 2-1,478). The median progression-free survival times were 5.8 months (95% CI 2.8-8.8) and 28.7 months (95% CI 13.4-43.9) in the groups with detectable and undetectable e-IL-10, respectively ( < 0.001).
Our results suggest that despite an objective response, the persistence of detectable e-IL-10 is associated with a high risk of early relapse in PCNSL. A closer follow-up of such patients is warranted.
尽管在诱导化疗的首次评估中反应率较高，但原发性中枢神经系统淋巴瘤（PCNSL）的早期复发风险仍然很高且难以预测。我们旨在评估诱导化疗 2 个月后脑脊液中早期白细胞介素-10 水平（e-IL-10）的预后价值。
我们从 LOC（眼脑淋巴瘤）网络数据库中回顾性选择了接受高剂量甲氨蝶呤为基础的一线化疗，在 2 个月评估时完全或部分缓解且 e-IL-10 可评估的 PCNSL 患者。
30 例患者（中位年龄：62 岁，30 例有脑受累，30 例有脑脊液受累，中位基线 CSF IL-10：27.5pg/ml）符合入选标准。22 例患者的 e-IL-10 不可检测，8 例患者的 e-IL-10 可检测。在诱导治疗结束时，8 例可检测 e-IL-10 的患者中有 7 例和 22 例不可检测 e-IL-10 的患者中有 4 例发生了疾病进展（ = 0.001，OR：26.8，95%CI 2-1，478）。可检测和不可检测 e-IL-10 的患者中位无进展生存期分别为 5.8 个月（95%CI 2.8-8.8）和 28.7 个月（95%CI 13.4-43.9）（ < 0.001）。
我们的结果表明，尽管存在客观缓解，但持续可检测到的 e-IL-10 与 PCNSL 的早期复发风险较高相关。需要对这类患者进行更密切的随访。
