Clinical features analysis on primary central nervous system lymphoma

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Author:
HAN Tian-jie(Department of Hematology, Huashan Hospital, Fudan University, Shanghai 200040, China)
CHEN Bo-bin(Department of Hematology, Huashan Hospital, Fudan University, Shanghai 200040, China)
X U Xiao-ping(Department of Hematology, Huashan Hospital, Fudan University, Shanghai 200040, China)
CHEN Zi(Department of Hematology, Huashan Hospital, Fudan University, Shanghai 200040, China)
JI Mei-rong(Department of Hematology, Huashan Hospital, Fudan University, Shanghai 200040, China)
LIN Guo-wei(Department of Hematology, Huashan Hospital, Fudan University, Shanghai 200040, China)
Journal Title:
Journal of Leukemia & Lymphoma
Issue:
Volume 20, Issue 10, 2011
DOI:
10.3760/cma.j.issn.1009-9921.2011.10.009
Key Word:
Central nervous systen neoplasms;Lymphoma, non-Hodgkin;Clinical features;Prognosis

Abstract: Objective To investigate the clinical features of patients with primary central nervous system lymphoma (PCNSL),to analyze and evaluate relevant prognostic factors and therapeutic regimens.Methods The retrospective study was conducted on 64 cases with PCNSL.The Log-rank test was applied to univariate analyses,whereas Cox regression was used in multivariate analyses on pertinent data of survival.Results The retrospective study was done on 64 newly diagnosed PCNSL cases.The median age was 54.9years old,and the overall male/female ratio was >1.Most of tumors (40/64) presented solely; 54 % (33/61) of all tumors were associated to deep lesions.Twenty-six patients with integrate analyzable data were diagnosed and treated at our hospital,among which,19 patients received chemotherapy alone; 1 patient received WBRT alone,and 6 received WBRT first,and chemotherapy one month later.The median survival time of all patients was 17 months.Statistically significant predictors shown in the univariate analyses were anemia degree and the use of HD-MTX and teniposide.Moderate to severe anemia alone was a significant predictor of bad prognosis,whereas chemotherapeutic regimens without HD-MTX and teniposide also showed bad prognosis. A combination of radiotherapy and chemotherapy had substantially improved their prognosis ( x2 =3.24,P =0.07).Age,gender,physical status and tumor location had not statistically significant on prognosis; CHOP regimen,rituximab,intrathecal injection of chemotherapeutic drug had non-significant impact on prognosis and survival.Cox-regression analysis for multivariate analyses on survival data showed the HD-MTX treatment was independent favorable predictor of prognosis; however, location and numbers of intracranial lesions,combination of radio and chemotherapy did not have independent prognostic impact on prognosis.Conclusion Prognosis of patients with PCNSL is extremely poor; HD-MTX or teniposide improve the prognosis and survival of patients.Prognosis of patients with moderate to severe anemia is even worse.

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