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A prospective observational study of real-world treatment and outcome in secondary CNS lymphoma

Item Type:Article
Title:A prospective observational study of real-world treatment and outcome in secondary CNS lymphoma
Creators Name:Habringer, S. and Demel, U.M. and Fietz, A.K. and Lammer, F. and Schroers, R. and Hofer, S. and Bairey, O. and Braess, J. and Meier-Stiegen, A.S. and Stuhlmann, R. and Schmidt-Hieber, M. and Hoffmann, J. and Zinngrebe, B. and Kaiser, U. and Reimer, P. and Möhle, R. and Fix, P. and Höffkes, H.G. and Langenkamp, U. and Büschenfelde, C.M.Z. and Hopfer, O. and Stoltefuß, A. and La Rosée, P. and Blasberg, H. and Jordan, K. and Kaun, S. and Meurer, A. and Unteroberdörster, M. and von Brünneck, A.C. and Capper, D. and Heppner, F.L. and Chapuy, B. and Janz, M. and Schwartz, S. and Konietschke, F. and Vajkoczy, P. and Korfel, A. and Keller, U.
Abstract:BACKGROUND: Secondary central nervous system lymphoma (SCNSL) confers a dismal prognosis and treatment advances are constrained by the lack of prospective studies and real-world treatment evidence. METHODS: Patients with SCNSL of all entities were included at first diagnosis and patient characteristics, treatment data, and outcomes were prospectively collected in the Secondary CNS Lymphoma Registry (SCNSL-R) (NCT05114330). FINDINGS: 279 patients from 47 institutions were enrolled from 2011 to 2022 and 243 patients (median age: 66 years; range: 23-86) were available for analysis. Of those, 49 (20 %) patients presented with synchronous (cohort I) and 194 (80 %) with metachronous SCNSL (cohort II). The predominant histology was diffuse large B-cell lymphoma (DLBCL, 68 %). Median overall survival (OS) from diagnosis of CNS involvement was 17·2 months (95 % CI 12-27·5), with longer OS in cohort I (60·6 months, 95 % CI 45·5-not estimable (NE)) than cohort II (11·4 months, 95 % CI 7·8-17·7, log-rank test p < 0.0001). Predominant induction regimens included R-CHOP/high-dose MTX (cohort I) and high-dose MTX/cytarabine (cohort II). Rituximab was used in 166 (68 %) of B-cell lymphoma. Undergoing consolidating high-dose therapy and autologous hematopoietic stem cell transplantation (HDT-ASCT) in partial response (PR) or better was associated with longer OS (HR adjusted 0·47 (95 % CI 0·25-0·89), p = 0·0197). INTERPRETATION: This study is the largest prospective cohort of SCNSL patients providing a comprehensive overview of an international real-world treatment landscape and outcomes. Prognosis was better in patients with SCNSL involvement at initial diagnosis (cohort I) and consolidating HDT-ASCT was associated with favorable outcome in patients with PR or better.
Keywords:Secondary Central Nervous System Lymphoma, SCNSL, Real-World Data, Registry Study, High-Dose Chemotherapy, Autologous Stem Cell Transplantation
Source:European Journal of Cancer
Page Range:113436
Date:January 2024
Official Publication:https://doi.org/10.1016/j.ejca.2023.113436
PubMed:View item in PubMed

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