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| Item Type: | Article |
|---|---|
| Title: | A prospective observational study of real-world treatment and outcome in secondary CNS lymphoma |
| Creators: |
Habringer, S.  ORCID: https://orcid.org/0000-0002-3976-9592, Demel, U.M. ORCID: https://orcid.org/0000-0002-6480-4185, Fietz, A.K. ORCID: https://orcid.org/0000-0002-4395-4176, Lammer, F., Schroers, R. ORCID: https://orcid.org/0000-0003-2744-5491, Hofer, S. ORCID: https://orcid.org/0000-0002-0831-2098, Bairey, O., Braess, J. ORCID: https://orcid.org/0000-0001-6528-2078, 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. ORCID: https://orcid.org/0000-0002-6758-7809, Blasberg, H., Jordan, K. ORCID: https://orcid.org/0000-0001-9379-5938, Kaun, S., Meurer, A., Unteroberdörster, M., von Brünneck, A.C. ORCID: https://orcid.org/0000-0003-4371-4292, Capper, D. ORCID: https://orcid.org/0000-0003-1945-497X, Heppner, F.L., Chapuy, B., Janz, M. ORCID: https://orcid.org/0000-0002-1127-0044, Schwartz, S. ORCID: https://orcid.org/0000-0001-8833-5793, Konietschke, F., Vajkoczy, P., Korfel, A. and Keller, U. ORCID: https://orcid.org/0000-0002-8485-1958
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| 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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