Primary central nervous system lymphoma in China: a single-center retrospective analysis of 167 cases

  • Xiang-Gui Yuan
  • Yu-Rong Huang
  • Teng Yu
  • Yang Xu
  • Yun Liang
  • Xiao-Hong Zhang
  • Chong-Ran SunEmail author
  • Xiao-Ying ZhaoEmail author
Original Article


Primary central nervous system lymphoma (PCNSL) is a rare form of extranodal non-Hodgkin’s lymphoma and a limited number of cases have been reported from China. This study aimed to investigate the clinicopathological features of newly diagnosed PCNSLs from a single center in eastern China and to identify the potential prognostic factors for overall survival (OS) and progression-free survival (PFS). All consecutive patients with histopathologically diagnosed PCNSLs at our center between January 2003 and October 2017 were recruited. Demographic and clinicopathological data were collected and reviewed retrospectively. The potential risk factors for OS and PFS were identified using the log-rank test and Cox regression analysis. A total of 167 immunocompetent cases were enrolled. The median age was 58 years (range 17–96 years), and the male:female ratio was 3:2. Headache (n = 65; 39%) and cerebral hemisphere (n = 96; 57%) were the most common presenting complaint and location, respectively. Out of 167 cases, 150 cases were diffuse large B cell lymphomas. With a median follow-up of 25 months (range 1–152 ), the median OS and PFS were 37 months (95% CI, 25–49) and 17 months (95% CI, 13–20), respectively. Residual tumor after operation, chemotherapy without HD-MTX and palliative treatment was revealed as independent prognostic markers. Moreover, ECOG > 3, multifocal lesions, and palliative treatment were revealed as unfavorable independent prognostic markers for PFS. In conclusion, Chinese patients with PCNSL have distinct characteristics. Further studies are warranted to confirm the prognostic value of these factors and to optimize treatments for these patients.


Extranodal non-Hodgkin’s lymphoma Primary central nervous system lymphoma Prognostic factors Multifocal lesions Surgery resection Chinese 



primary central nervous system lymphoma


non-Hodgkin’s lymphoma


human immunodeficiency virus


diffuse large B cell lymphoma


germinal center B cell


non-germinal center B cell


international Extranodal Lymphoma Study Group


lactate dehydrogenase


cerebrospinal fluid


overall survival


Karnofsky scores


progression-free survival


absolute lymphocyte count


magnetic resonance imaging


high-dose methotrexate


autologous stem cell transplantation


Authors’ contributions

XG Yuan analyzed the patient data and wrote the manuscript. Yu-Rong Huang, T Yu, Y Liang, and XH Zhang collected clinical data; Y Xu performed the statistical analysis; Xiao-Ying Zhao designed and supervised the research project. CR Sun analyzed and interpreted the patient data regarding the surgery and evaluations of cranial magnetic resonance (MRI). All authors read and approved the final manuscript.

Funding information

This work was supported by Zhejiang Provincial Key Innovation Team (No. 2011R50015), National Natural Science Foundation of China grants (No. 81572920), National Basic Research Program of China (No. 2013CB911303), and Natural Science Foundation of Zhejiang Province of China (No. LY15H160038).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

This study was approved by the Human Ethics Committee of the Second Affiliated Hospital, School of Medicine, Zhejiang University, China.

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

An informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Hematology, the Second Affiliated HospitalZhejiang University School of MedicineHangzhouChina
  2. 2.Department of Neurosurgery, the Second Affiliated HospitalZhejiang University School of MedicineHangzhouChina

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