Blood Res.  2017 Dec;52(4):285-292. 10.5045/br.2017.52.4.285.

Primary central nervous system lymphoma: a new prognostic model for patients with diffuse large B-cell histology

• Ahn Y
• Ahn HJ
• Yoon DH
• Hong JY
• Yoo C
• Kim S
• Huh J
• Suh C

• KMID: 2405065
• DOI: http://doi.org/10.5045/br.2017.52.4.285

Abstract

BACKGROUND
Age and performance status are important prognostic factors in primary central nervous system (CNS) lymphoma. Although several prognostic models have been proposed, there is no consensus on the optimal model for patients with diffuse large B-cell histology.
METHODS
Seventy-seven patients with primary CNS diffuse large B-cell lymphoma were retrospectively analyzed to determine factors affecting survival. Three Western models were applied to our eligible patients; we devised a novel model based on our findings.
RESULTS
The median patient age was 59 years (range, 29-77); the median event-free and overall survival (OS) durations were 35.9 and 12.6 months, respectively. Nottingham/Barcelona and Memorial Sloan Kettering Cancer Center models were applicable to our cohorts. Multivariate analysis showed that advanced age, multifocal lesions, and high cerebrospinal fluid (CSF) protein concentrations were correlated significantly. A novel model for predicting prognosis was then developed based on these variables. Each variable was assigned 1 point; patients with a total score of 0, 1, 2, and 3 were categorized into the low- (N=17), moderate- (N=26), high- (N=14), and very high-risk groups (N=4), respectively. Sixty-one patients were eligible considering our model; the median OS was 58.2, 34.8, 9.0, and 1.8 months in the low-, moderate-, high-, and very high-risk groups, respectively (P < 0.01).
CONCLUSION
Advanced age, multifocal lesions, and high CSF protein concentration were adversely related with prognosis. Our model can be helpful in pre-treatment risk stratification for patients with primary CNS lymphoma with diffuse large B-cell histology.

Keyword

Central nervous system; Lymphoma; Prognosis; Survival

MeSH Terms

B-Lymphocytes*
Central Nervous System*
Cerebrospinal Fluid
Cohort Studies
Consensus
Humans
Lymphoma*
Lymphoma, B-Cell
Multivariate Analysis
Prognosis
Retrospective Studies

Figure

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  Fig. 1 International Extranodal Lymphoma Study Group (IELSG) model in our cohort.

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  Fig. 2 Nottingham/Barcelona model in our cohort.

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  Fig. 3 Memorial Sloan-Kettering Cancer Center (MSKCC) model in our cohort.

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  Fig. 4 Newly proposed Asan Medical Center (AMC) prognostic model.

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