title: Primary B-cell CNS lymphoma clinicopathologic and treatment outcomes in 89 patients from a single tertiary care center.
abstract: Primary central nervous system lymphoma (PCNSL) is a rare aggressive variant of diffuse large B-cell lymphoma with a poor prognosis and no defined optimal therapeutic strategies. Our aim was to compare the role of intrathecal chemotherapy with current high-dose methotrexate (HDMTX) treatments. Clinicopathologic characteristics, therapy, and outcomes of patients with PCNSL at Moffitt Cancer Center were reviewed in 89 patients identified over an 11-year period. Patients treated initially with HDMTX-based therapy showed improved overall and progression-free survival, with no improvement shown with added radiation or intrathecal therapy. Age and performance status were also important prognostic indicators. Our conclusion is that initial therapy in PCNSL should include an HDMTX backbone. The use of intrathecal chemotherapy or radiation therapy initially likely does not improve outcomes. Future multicenter phase III clinical trials are needed to better establish the superior initial treatment in PCNSL.
authors.affiliation: Department of Malignant Hematology, H. Lee Moffitt Cancer Center and Research Institute, and the University of South Florida, 12902 Magnolia Drive, Tampa, FL, 33602, USA, sdalia@gmail.com.
authors.forename: Samir
authors.initials: S
authors.lastname: Dalia
authors.forename: Peter
authors.initials: P
authors.lastname: Forsyth
authors.forename: Julio
authors.initials: J
authors.lastname: Chavez
authors.forename: Samantha
authors.initials: S
authors.lastname: Price
authors.forename: Bijal
authors.initials: B
authors.lastname: Shah
authors.forename: Celeste
authors.initials: C
authors.lastname: Bello
authors.forename: Lubomir
authors.initials: L
authors.lastname: Sokol
authors.forename: Edward
authors.initials: E
authors.lastname: Pan
authors.forename: Eduardo
authors.initials: E
authors.lastname: Sotomayor
authors.forename: Ji-Hyun
authors.initials: JH
authors.lastname: Lee
authors.forename: Kate
authors.initials: K
authors.lastname: Fisher
authors.forename: Michael
authors.initials: M
authors.lastname: Jaglal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016543:Central Nervous System Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D005260:Female; D006801:Humans; D016393:Lymphoma, B-Cell / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D011878:Radiotherapy; D012189:Retrospective Studies; D012307:Risk Factors; D000069283:Rituximab; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D008727:Methotrexate