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

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Item Type:	Article
Title:	A prospective observational study of real-world treatment and outcome in secondary CNS lymphoma
Creators Name:	Habringer, S., Demel, U.M., Fietz, A.K., Lammer, F., Schroers, R., Hofer, S., Bairey, O., Braess, J., Meier-Stiegen, A.S., Stuhlmann, R., Schmidt-Hieber, M., Hoffmann, J., Zinngrebe, B., Kaiser, U., Reimer, P., Möhle, R., Fix, P., Höffkes, H.G., Langenkamp, U., Büschenfelde, C.M.Z., Hopfer, O., Stoltefuß, A., La Rosée, P., Blasberg, H., Jordan, K., Kaun, S., Meurer, A., Unteroberdörster, M., von Brünneck, A.C., Capper, D., Heppner, F.L., Chapuy, B., Janz, M., Schwartz, S., Konietschke, F., Vajkoczy, P., 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
ISSN:	0959-8049
Publisher:	Elsevier
Volume:	196
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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