Primary central nervous system lymphoma: Inter-compartmental progression

Vishal Raval; Elaine Binkley; Mary E Aronow; Juan Valenzuela; David M Peereboom; Wei Wei; Sunil Srivastava; Jaqueline Davanzo; Herbert Culver Boldt; Mark P McGarrey; George N Papaliodis; Lucia Sobrin; Ivana K Kim; Dimitrios G Vavvas; Dean Eliott; Lakshmi Nayak; Emilio Dodds; Francisco Marco Del Pont; Arun D Singh

doi:10.1002/jha2.303

Primary central nervous system lymphoma: Inter-compartmental progression

EJHaem. 2022 Jan 20;3(2):362-370. doi: 10.1002/jha2.303. eCollection 2022 May.

Authors

Vishal Raval¹, Elaine Binkley², Mary E Aronow³, Juan Valenzuela⁴, David M Peereboom⁵, Wei Wei⁶, Sunil Srivastava¹, Jaqueline Davanzo¹, Herbert Culver Boldt², Mark P McGarrey³, George N Papaliodis³, Lucia Sobrin³, Ivana K Kim³, Dimitrios G Vavvas³, Dean Eliott³, Lakshmi Nayak⁷, Emilio Dodds⁴, Francisco Marco Del Pont⁸, Arun D Singh¹

Affiliations

¹ Department of Ophthalmic Oncology Cole Eye Institute Cleveland Clinic Cleveland Ohio USA.
² Department of Ophthalmology and Visual Sciences University of Iowa Iowa City Iowa USA.
³ Retina Service, Massachusetts Eye and Ear Harvard Medical School Boston Massachusetts USA.
⁴ Department of Retina and Ophthalmic Oncology Consultores Oftalmológicos Buenos Aires Argentina.
⁵ The Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center Cleveland Clinic Cleveland Ohio USA.
⁶ Department of Quantitative Health Sciences Lerner Research Institute Cleveland Clinic Cleveland Ohio USA.
⁷ Center for Neuro-Oncology Dana-Farber Cancer Institute Boston Massachusetts USA.
⁸ Department of neurosurgery Fleni Buenos Aires Argentina.

Abstract

There is limited understanding of the inter-compartmental progression and treatment outcomes of primary central nervous system lymphoma (PCNSL). In this multicenter retrospective cohort study on 234 patients with PCNSL (median age: 62.5 years [18-92]; median follow-up 35 months [0.1-237.0]) from 2000 till 2018 were divided into group 1 (ocular, 44 patients): 1A and 1B without and with CNS progression and group 2 (CNS, 190 patients): 2A and 2B without and with ocular progression, respectively. In group 1 (44 patients), 33 patients received local treatment, and 11 patients received systemic treatment. In group 2 (15 patients), six patients received combination treatment, while seven patients received only systemic treatment. A complete response was observed in 19 (43%) and 91 (48%) patients in groups 1 and 2, respectively. The 2-year progression-free survival (PFS) was 35% (95% CI: 0.23, 0.54) and 56% (95% CI: 0.49, 0.63) for groups 1 and 2, respectively (p < 0.0001). Age < 60 years was significantly associated with longer PFS (median PFS 48 vs. 24 months, p = 0.01). The overall survival (OS) at 2-year was similar among groups 1 and 2 (83% and 67%), respectively (p = 0.06). Thus, Initial compartment of involvement does not influence local response rate or OS.

Keywords: inter‐compartment; primary central nervous system lymphoma; primary central nervous system lymphoma‐ocular variant; primary vitreoretinal lymphoma; progression; treatment.