Document Type
Article
Publication Date
4-24-2025
Abstract
BACKGROUND: Primary central nervous system lymphoma (PCNSL) is a rare and aggressive variant of non-Hodgkin lymphoma. While PCNSL is often sensitive to induction high-dose methotrexate (HDMTX) based chemotherapy, recurrence rates remain high, approaching 50% within 5 years. The most common molecular alterations in PCNSL include mutations in MYD88 and CD79 and CDKN2A homozygous deletion. There are no predictive or prognostic molecular markers in PCNSL.
METHODS: We conducted a retrospective review of 40 patients with PCNSL treated at Thomas Jefferson University and Ohio State University between 2011 and 2023. We created a clinically annotated database of patient characteristics and outcomes. For 13 patients whose paraffin-embedded tissue was available for analysis, Illumina's Infinium Global Diversity Array with Cytogenetics was used to make copy number change calls.
RESULTS: The most commonly used induction chemotherapy regimens were HDMTX monotherapy and HDMTX with rituximab. The overall response rate to induction chemotherapy was 75%. A total of 25% had resistant disease to induction chemotherapy. The median follow-up was 20.3 months. The median progression-free survival for the entire cohort was 30.64 months (range 3.42-57.86 months); 2.56 months for the resistant group and 44.88 months for the sensitive group (P-value < .001). The median overall survival for the entire cohort was 64.8 months (range 41.47-88.13 months); 13.97 months for the resistant group and 81.43 months for the sensitive group (P-value = .046).
CONCLUSIONS: The initial response to induction chemotherapy is an important prognostic factor in PCNSL. There is a need for improved predictive biomarkers of response to treatment in PNCLS.
Recommended Citation
Cappelli, Louis; Kayne, Allison; Newman, Jennifer; Elguindy, Ahmed; Epperla, Narendranath; Palmer, Joshua D.; Martinez-Outshoorn, Ubaldo E.; Porcu, Pierluigi; Shi, Wenyin; and Alnahhas, Iyad, "Primary Central Nervous System Lymphoma: Predictors of Response to Induction Therapy and Patterns of Progression" (2025). Department of Radiation Oncology Faculty Papers. Paper 213.
https://jdc.jefferson.edu/radoncfp/213
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
PubMed ID
40575413
Language
English
Comments
This article is the author's final published version in Neuro-Oncology Advances, Volume 7, Issue 1, 2025, vdaf082.
The published version is available at https://doi.org/10.1093/noajnl/vdaf082.
Copyright © The Author(s) 2025