Primary central nervous system lymphoma in China: a single-center retrospective analysis of 167 cases
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.
KeywordsExtranodal non-Hodgkin’s lymphoma Primary central nervous system lymphoma Prognostic factors Multifocal lesions Surgery resection Chinese
primary central nervous system lymphoma
human immunodeficiency virus
diffuse large B cell lymphoma
germinal center B cell
non-germinal center B cell
international Extranodal Lymphoma Study Group
absolute lymphocyte count
magnetic resonance imaging
autologous stem cell transplantation
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.
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.
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.
An informed consent was obtained from all individual participants included in the study.
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